重症老年呼吸机相关性肺炎患者的病原耐药性及预防措施分析

Analysis of pathogen resistance and preventive measures of elderly patients with ventilator associated pneumonia

目的探讨ICU重症老年呼吸机相关性肺炎患者的病原耐药性及预防措施。方法选取2013年4月~2014年4月收治的90例发生呼吸机相关性肺炎的ICU重症老年患者作为研究对象,回顾性分析患者的临床资料、气道分泌物病原学和病菌耐药性。结果本研究共培养病原菌154株,其中革兰阴性菌94株（61.04%）,革兰阳性菌35株（22.73%）,真菌20株（12.99%）,非典型病原体5株（3.25%）。根据药敏试验结果,革兰阴性菌中的大肠埃希菌、铜绿假单胞菌、鲍曼不动杆菌、肺炎克雷伯杆菌、嗜麦芽黄单胞菌均具有较强的抗生素耐药性。结论 ICU重症老年呼吸机相关性肺炎患者的病原主要为革兰阴性菌,并且革兰阴性菌中的多个菌种具有较强、较多的抗生素耐药性,因此临床应加强预防措施以减少肺炎感染。

Objective To study the pathogen resistance and preventive measures of elderly patients with ventilator associated pneumonia. MethodsNinety elderly patients with ventilator associated pneumonia were treated in ICU of our hospital from April 2013 to April 2014. Retrospective analysis of the airway secretion pathogens and drug resistance of patients. Results 154 strains of pathogenic bacteria were cultivated in this study. In which, 94 isolates（61.04%） were gram-negative bacterium, 35 isolates（22.73%） were gram-positive bacterium, 20 isolates（12.99%） were fungus, 5 isolates（3.25%）were atypical pathogen. The escherichia coli, Pseudomonas aeruginosa, Acinetobacter Bauman, Klebsiella pneumoniae and Pseudomonas aeruginosa in gram-negative bacterium had strong antibiotic resistance. Conclusion The gram-negative bacterium are main pathogens of patients with ventilator associated pneumonia. Multiple strains of gram negative bacteria have stronger and more antibiotic resistance. Therefore, preventive measures should be strengthened to reduce pneumonia infection.