摘要
目的探讨引起ICU呼吸机相关性肺炎病原菌菌种分布及耐药谱,为临床合理使用抗菌药物提供依据。方法对重症监护病房近3年机械通气患者临床标本中分离的致病菌进行比较分析。结果共检出致病菌205株,其中革兰阴性细菌145株(70.73%),真菌38株,(18.54%),革兰阳性细菌22株(10.73%)。非发酵菌和肠杆菌科细菌是主要病原菌。非发酵菌以铜绿假单胞菌、鲍曼不动杆菌和嗜麦芽窄食单胞菌较多见。肠杆菌科细菌以阴沟肠杆菌、肺炎克雷伯菌和大肠杆菌为多。所测定菌株均呈高度耐药。结论革兰阴性菌是VAP的主要致病菌,真菌感染不容忽视。病原菌呈现出多重耐药现象,在经验性抗感染治疗时应考虑对常见致病菌有较好覆盖率且耐药性较低的抗生素,同时积极开展病原学检查,指导合理有效使用抗菌药物。
Objective To analyse pathogens and drug - resistance in ventilator - associated pneumonia（ VAP）, and to provide the rational antibiotic strategies. Methods We analysed 82 VAP patient＇ s clinical data, pathogens distribution and resistance rate of pathogens in ICU in recent three years. Results 205 pathogenic germs had been examined, including 145gram - negative bacilli（ accounted for 70.73% ） , 38 fungi（ 18.54% ） and 22 gram - positive bacteria（ 10.73% ）. The major pathogens were Pseudomonas aeruginosa, Acinetobacter baumanii, Pseudomonas maltophilia, Escherichia cloacae, Klebsiella pneumoniae and Escherichia coil Most of gram - negative bacilli showed high resistance rate to common used antibiotics. Conclusions Gram - negative bacilli were the major pathogens for VAP but fungi should not been ignored. Multi - drug - resistance could be occurred in most of the pathogens. Broad - spectrum antibiotics with lower drug - resistance characteristics should be taken into account in Empirically antibiotic therapy. Meanwhile, exploring pathogens regularly were helpful for choosing antibiotics.
出处
《医学研究杂志》
2007年第7期21-23,共3页
Journal of Medical Research
关键词
呼吸机相关性肺炎
病原学
耐药性
Ventilator- associated pneumonia（VAP）
Pathogen
Drug resistance
