摘要
目的了解机械通气早产儿下呼吸道定植细菌菌谱，并进一步探讨呼吸机相关性肺炎（YAP）的病原学细菌谱及耐药性。方法对2004年1月～2005年12月我院早产儿监护病房住院的165例机械通气患儿行支气管肺泡灌洗液定量培养和药敏试验，进行细菌监测。结果机械通气3d以上的患儿全部出现下呼吸道的细菌定植，其中有37．5％（62／165）的患儿诊断为VAP。支气管肺泡灌洗液定量培养均以G一杆菌为主，其中肺炎克雷自杆菌、铜绿假单胞菌、鲍曼不动杆菌分别占前3位；VAP的病原菌耐药性分析显示对头孢类抗生素广泛耐药，而对亚胺培南．西司他丁、头胞哌酮／舒巴坦钠、环丙沙星仍保持较高敏感性。结论G^-杆菌是机械通气患儿下呼吸道定植和VAP的优势菌群，对目前临床常用抗生素有多重耐药现象。
Objective To analyze bacterial colonization in lower respiratory tract（LRT） in ventilated premature and to determine pathogens and drug resistance of ventilation associated pneumonia（VAP）. Meth- ods Bacterial surveillance was done on 165 ventilated premature infants enrolled in our study from Jan 2004 to Dec 2005 by bronchoalveolar lavage culture and drug resistance. Results All of patients who were ventilated over 3 days showed bacterial colonization in LRT, of whom 37.5 96 （62/165） were diagnosed VAP. Gram- negative shared major proportion in both bacterial colonization in LRT and pathogens for VAP. Multidrug-re- sistance of Gram-negative bacteria to antimicrobial agents was serious in patients with VAP, Conclusion Gram-negative bacteria are the majority of the pathogens isolated from ventilated premature infants in NICU. It is suggested that the urgent need for surveillance of bacterial resistance and rational use of antimicrobial a- gents during clinical therapy.
出处
《中国小儿急救医学》
CAS
2007年第5期390-393,共4页
Chinese Pediatric Emergency Medicine
关键词
机械通气
病原菌谱
定植
呼吸机相关性肺炎
早产儿
Mechanical Ventilation
Pathogens
Colonization
Ventilator associated pneumonia
Prema-ture infant
