摘要
目的:探讨重症监护病房(ICU)呼吸机相关性肺炎(VAP)的病原学分布及其耐药性。方法:选择100例ICU收治的VAP患者,对其病原学检查结果进行回顾性分析。结果:100例VAP患者中共分离出135株病菌,包括革兰氏阴性杆菌95株(占70.5%),革兰氏阳性球菌34株(占25.1%)和真菌6株(占4.4%);革兰氏阴性杆菌中的铜绿假单胞菌和肺炎克雷伯菌对头孢唑林、庆大霉素、左氧氟沙星和复方新诺明的耐药率均较高;革兰氏阳性球菌中的金黄色葡萄球菌对头孢他啶、头孢曲松、头孢吡肟、头孢唑林、庆大霉素、阿米卡星、环丙沙星、左氧氟沙星、头孢哌酮、舒巴坦和哌拉西林的耐药率均较高。结论:ICU中VAP患者的病原菌分布以革兰氏阴性菌为主,并表现出多重耐药,致病菌大多对亚胺培南和头孢哌酮、舒巴坦敏感,可借鉴应用。
Objective： To explore the etiology and drug resistance of the ICU ventilator-associated pneumonia. Methods： One hundred cases of patients with ventilator-associated pneumonia received in our ICU room were selected; the pathologic examination results were retrospectively analyzed. Results： One hundred and thirty five bacteria were isolated from 100 cases of patients with ventilator-associated pneumonia, including 95 cases of Gram-negative bacilli（70.5%）, 34 cases of Gram-positive cocci（25.1%） and 6 cases of fungi（4.4%）; The resistance rates of Pseudomonas aeruginosa and Klebsiella pneumoniae for cefazolin, gentamicin, levofloxacin, and trimethoprim-sulfamethoxazole were high; The resistance rate of Staphylococcus aureus for ceftazidime, ceftriaxone, cefepime, cefazolin, gentamicin, amikacin, ciprofloxacin, levofloxacin, cefoperazone/sulbactam and piperacillin were high. Conclusion： ICU ventilator-associated pneumonia pathogen was mainly Gram-negative bacteria, and showed multidrug resistance, imipenem and cefoperazone/sulbactam for most pathogens had better efficacy and worthy of clinical application.
出处
《中国医学装备》
2016年第1期111-113,共3页
China Medical Equipment
关键词
重症监护病房
呼吸机相关性肺炎
耐药性
病原菌
Intensive care unit
Ventilator-associated pneumonia
Drug resistance
Pathogens
