摘要
目的分析ICU内呼吸相关性肺炎的病原学及药敏特性，以指导临床抗生素的使用。方法回顾性分析2007年1月至10月急诊ICU收治的57例机械通气患者合并呼吸相关性肺炎的致病菌及药敏情况。结果共检出致病菌145株。其中革兰氏阴性菌75株，占51．72％；革兰氏阳性菌38株，占26．21％；真菌32株，占22．07％。前四位致病菌分别为：铜绿假单胞菌、金黄色葡萄球菌、白色念珠菌、肺炎克雷伯杆菌。药敏显示革兰氏阴性菌对亚胺培南、左旋氧氟沙星、美洛培南、丁胺卡那霉素较敏感；革兰氏阳性菌对替考拉宁、万古霉素、利奈唑烷、褐霉素、磷霉素敏感；真菌对伊曲康唑、两性霉素、氟康唑敏感。结论呼吸相关性肺炎的致病菌构成以革兰氏阴性菌为主，真菌感染呈上升趋势，抗菌治疗应依据当地病原学流行特点并结合药敏结果进行。
Objective To analyse the pathogenesis of ventilator associated pneumonia （ VAP ） and their resistance to antibiotics and to guide treatment with antibiotics. Methods A retrospective clinical study in 57 ICU patients with VAP was carried out from 2007.1 to 2007.10. The pathogens and their drug resistance were analyzed, Results A total of 145 pathogen strains were isolated and identified by bacterial culture. The pathogenic bacteria in VAP was the Gram-negative bacilli （ GNB, 51.72% ）, Gram-positive bacteria （ GPB, 26.21% ）, fungi （ 22.07% ）. The major bacteria was pseudomonas semginosa, staplyloeoccus sureus, candida albicans and klebsiella pneumoniae. Drug sensitivity tests indicated that the GNB had lower drug resistance to imipenem, levofloxacin, meropenam, amikacin; the GPB had lower drug resistance to teicoplanin, vancomycin, linezolid, fusidate, fosfomycin; the fungi had lower drug resistance toitraconazole, amphotericin, fluconazole. Conclusions The major pathogens in VAP were GNB and fungi infection were increased in recent years. Epidemiology and drug sensitivity tests of pathogens must be consided when we treat VAP in ICU.
出处
《国际医药卫生导报》
2010年第3期336-339,共4页
International Medicine and Health Guidance News
关键词
ICU
呼吸相关性肺炎
病原学
药敏
ICU
Respiratory-associatedpneumonia
Etiology
Susceptibility
