急诊重症患者呼吸机相关性肺炎的病原学特点及其耐药性分析

Pathogenic characteristics and drug resistance of ventilator-associated pneumonia in emergency patients with crtical illness

目的探讨急诊重症患者呼吸机相关性肺炎的病原学特点及其耐药性。方法抽取2020年1月至2021年12月安阳市人民医院收治的91例急诊重症呼吸机相关性肺炎患者作为研究对象,采集患者的痰标本,并进行细菌培养及药敏试验,对其病原菌分布状况及耐药情况进行回顾性分析。结果91例呼吸机相关性肺炎患者中共分离出138株病菌,包括革兰阴性杆菌92株(66.67%)、革兰阳性球菌39株(28.26%)及真菌7株(5.07%),其中以铜绿假单胞菌、肺炎克雷伯菌、金黄色葡萄球菌为主,分别占31.16%、18.84%、15.94%。铜绿假单胞菌、肺炎克雷伯菌对碳青霉烯类抗生素及氨基糖苷类抗生素较敏感;革兰阳性球菌对恶唑烷酮类、糖肽类抗生素敏感性较高。结论急诊重症患者呼吸机相关性肺炎主要以革兰阴性菌感染为主,金黄色葡萄球菌也占有较大比例。根据病原菌耐药结果合理使用抗菌药物,能降低耐药状况的发生,提升临床治疗效果。

Objective To investigate the pathogenic characteristics and drug resistance of ventilator-associated pneumonia(VAP)in emergency patients with crtical illness.Methods A total of 91 emergency patients with crtical illness complicated by severe VAP who were treated in to Anyang People’s Hospital from January 2020 to December 2021 were selected as the research objects.The sputum samples were collected from the research objects,while bacterial culture and drug sensitivity test were conducted.The distribution and drug resistance of pathogenic bacteria were analyzed retrospectively.Results A total of 138 strains of bacteria were isolated from 91 patients with VAP,including 92 strains(66.67%)of gram-negative bacilli,39 strains(28.26%)of gram-positive cocci and 7 strains(5.07%)of fungi;Pseudomonas aeruginosa,Klebsiella pneumoniae and Staphylococcus aureus were the main bacteria,accounting for 31.16%,18.84%and 15.94%,respectively.Pseudomonas aeruginosa and Klebsiella pneumoniae were more sensitive to carbapenem antibiotics and aminoglycoside antibiotics.Gram-positive cocci are highly sensitive to oxazolidinones and glycopeptides.Conclusions Most of emergency patients patients with crtical illness complicated by VAP are infected by gram-negative bacteria,while Staphylococcus aureus infection accounts for a large proportion,too.The rational use of antibiotics according to the drug resistance results of pathogenic bacteria can reduce the occurrence of drug resistance and improve the clinical treatment effect.