新生儿呼吸机相关性肺炎病原菌检测及药敏分析

目的:探讨新生儿重症监护病房(NICU)呼吸机相关肺炎(Ventilator Associated Pneumonia,VAP)临床病原菌的特点,指导临床合理使用抗菌药。方法:回顾性分析发生VAP的91例患儿的临床特点、病原菌分布情况与耐药特性。结果:91例VAP患儿共培养出116株病原菌,排前5位的依次是铜绿假单胞菌,肺炎克雷伯菌,大肠埃希菌,白色念珠菌,革兰阳性(G+)球菌;而革兰阴性(G-)杆菌对阿米卡星、泰能和哌拉西林舒巴坦较敏感;G+球菌对万古霉素均敏感。结论:NICU病房VAP病原菌以G-杆菌为主,耐药率高,真菌感染不可忽视,临床应根据病原菌的药敏试验合理选择抗菌用药。

Pathogenic bacteria detection and drug sensitivity analysis in newborn babies with ventilator-associated pneumonia

Objective To survey the characteristics of bacteria causing ventilator associated pneumonia（VAP） in NICU,and to give direction for the rational using antimicrobial in clinic.Methods Clinical characteristics and antimicrobial resistance of 91 cases bacteria causing VAP during September 2005～October 2009 were analyzed.Results Among 116 bacteria strains detected from 91 cases with VAP,Pseudomonas aeruginosa was the major to Piperacillin and Sulbactam、Amikacin and Imipenem/ Cilastatin.The sensitive rates of strains to Vancomycin were all 100%.Conclusion Gram-negative bacteria are the main pathogens causing VAP in newborns in NICU,and has high drug tolerance;fungi comes as the second place,clinicians should choose antimicrobial agents according to pathogen and antimicrobial susceptibility test conclusion.