重症监护病房呼吸机相关性肺炎病原菌分布及耐药性分析

Distribution and drug resistance of the pathogens of ventilator- associated pneumonia in intensive care units

目的观察重症监护病房呼吸机相关性肺炎（ventilatorassociatedpneumonia，VAP）病原菌分布特点及其耐药情况，为临床用药提供指导。方法回顾性的分析2012年1月-2014年12月收住ICU的机械通气中并发VAP的患者，分析其病原菌分布及耐药情况。结果198例vAP患者的下呼吸道分泌物共分离出313株病原菌，其中革兰阴性菌占86．26％，革兰阳性菌占7．67％，真菌占6．07％。革兰阴性菌以鲍曼不动杆菌、铜绿假单胞菌为主，存在多重耐药现象。结论呼吸机相关性肺炎的病原菌以G-菌为主，抗生素耐药严重，应合理使用抗生素。

Objective To investigate the distribution and drug resistance of the pathogens of ventilator- associated pneumonia （VAP） in intensive care unit （ICU）. Methods Retrospective analysis was performed using the data from VAP patients under mechanical ventilation in ICU from 2012 to 2014. Meanwhile, their pathogen distribution and drug resistance were analyzed. Results There were 313 strains of pathogens isolated from the lower respiratory tract sputum specimens in 198 patients, where the gram-negative bacteria accounted for the highest （86.26%）, while the gram-positive bacteria and the fungi were 7.67% and 6.07% ,respectively. The gram-negative bacteria were mainly Acinetobacter baumannii and Pseudomonas aeruginosa. Meanwhile, polyresistance existed. Conclusion The pathogens of VAP were mainly gram-negative bacteria with serious antibiotic resistant. Antibiotics should be rationally used.