呼吸机相关性肺炎的危险因素及病原菌的耐药性

目的 探讨医院呼吸机相关性肺炎(VAP)的危险因素与病原菌耐药性,为临床预防治疗VAP提供参考依据.方法 回顾性调查212例VAP患者的资料,统计分析其基础疾病、机械通气方式、感染病原菌种类、耐药率等.结果 212例VAP患者均患有严重的基础疾病;机械通气的插管方式为经口(鼻)气管插管及气管切开等;VAP病原菌以革兰阴性菌为主,占75.0％,其中铜绿假单胞菌(PAE)分离率最高,达22.3％;肺炎克雷伯菌(KPN)居第2位(16.5％);革兰阳性菌中耐甲氧西林金黄色葡萄球菌(MRSA)检出率为8.0％;VAP病原菌均出现较强的耐药性.结论 务必制定有效的VAP防治措施,降低VAP发病率,提高临床治愈率.

Risk factors for ventilator-associated pneumonia and antimicrobial resistance

OBJECTIVE To explore the risk factors and antimicrobial resistance in ventilator-associated pneumonia(VAP) and to provide the reference for its clinical prevention and treatment.METHODS The retrospective review was performed on 212 cases of VAP.The primary diseases,mode of mechanical ventilation,bacterial species,antimicrobial resistance,and so on were analyzed statistically.RESULTS A total of 212 patients with VAP had severe primary diseases.The tracheal intubations were through mouth,nose or incision of trachea.The majority of pathogens were gram-negative bacteria(75.0%) in which Pseudomonas aeruginosa were with the highest isolation rate(22.3%),followed by Klebsiella pneumoniae(16.5%).The detection rate of MRSA among gram-positive bacteria was 8.0%;the pathogens causing VAP showed serious drug resistance.CONCLUSION It′s necessary to institute effective measures for prevention and treatment of VAP in order to reduce the incidence of VAP and raise the clinical cure rate.