住院ICU呼吸机相关肺炎患者革兰阴性菌感染状况研究

Study on infection status of gram-negative bacteria in inpatient ICU ventilator-associated pneumonia

目的探究住院ICU呼吸机相关肺炎患者革兰阴性菌感染状况。方法回顾性分析2012年12月-2017年12月医院收治的358例进入ICU救治发生革兰阴性菌呼吸机相关肺炎患者为研究对象,对患者进行下呼吸道分泌物培养和药物敏感性实验,统计患者病原菌培养和药物敏感性结果。结果 358例革兰阴性菌感染患者中,以铜绿假单胞菌为主,122株占34.08%,其次为鲍氏不动杆菌84株占23.46%;革兰阴性菌药物敏感性结果显示绝大部分病原菌呈现多重耐药性,检测出10株全耐药鲍氏不动杆菌,15株全耐药铜绿假单胞菌;联合用药相较于单一用药能够降低革兰阴性菌耐药率,差异具有统计学意义(P<0.05)。结论呼吸机相关肺炎其革兰阴性菌耐药发生率升高,联合用药能够降低革兰阴性菌耐药率。

OBJECTIVE To investigate the prevalence of gram-negative bacteria in patients with ventilator-associated pneumonia in hospital ICU. METHODS A retrospective analysis of 358 patients admitted to the ICU of our hospital from Dec. 2012 to Dec. 2017 with occurrence of ventilator-associated pneumonia caused by gram-negative bacteria was conducted. Respiratory secretions culture and drug susceptibility testing were conducted for the patients, and the results of pathogen culture and drug sensitivity test were analyzed. RESULTS P aeruginosa was the major pathogen in the 358 VAP patients infected with gram-negative bacteria, with 122 strains accounting for 34.08%, followed by 84 strains of Acinetohacter baumannii accounting for 23.46%. The drug sensitivity test o￡ gram-negative bacteria showed that most of the pathogens had multi-drug resistance. 10 strains of A baumannii and 15 strains of P aeruginosa were resistant to all kinds of antimicrobial agents. The combination therapy was superior to single drug treatment in reducing the resistance rates of gram-negative bacteria, and the difference was significant (P<0.05). CONCLUSION The incidence of drug resistance among gram-negative bacteria in ventilator-associated pneumonia is increased, and the combination therapy can reduce the resistance rates of gram-negative bacteria.