呼吸机相关性肺炎常见病原菌分布及耐药性分析

目的 了解呼吸机相关性肺炎病原菌分布和耐药性,为临床早期、合理、有效地使用抗生素提供可靠的依据,避免多重耐药的发生。方法 分析临床确诊为呼吸机相关性肺炎患者51例痰标本分离的病原菌112株。采用法国梅立埃鉴定和药敏测定系统进行病原菌鉴定和药物敏感性检测。结果 112株病原菌中以革兰氏阴性杆菌为主,占75.89%,主要为鲍曼不动杆菌、铜绿假单胞菌、肺炎克雷伯、嗜麦芽寡养单胞菌和大肠埃希菌。革兰氏阳性菌占16%,以金黄色葡萄球菌为主。真菌占11%,以白色念珠菌为主。鲍曼不动杆菌、铜绿假单胞菌耐药严重,鲍曼不动杆菌对头孢类、青霉素类、喹诺酮类、碳青霉烯类耐药率大于50%,铜绿假单胞菌对氨苄西林/舒巴坦耐药率为100%。结论 呼吸机相关性肺炎病原菌多重耐药或泛耐药比例较高,临床应根据耐药性监测数据合理使用抗生素。

Analysis on the distribution and drug resistance of common pathogenic bacteria of ventilator-associated pneumonia

Objective To investigate the distribution and drug resistance of pathogenic bacteria of ventilator-associated pneumonia and provide reliable evidence for the early,rational and effective use of antibiotics to avoid the occurrence of multidrug resistance.Methods A total of 51 patients with ventilator-associated pneumonia were analyzed.112 strains of pathogenic bacteria were isolated from sputum samples.The identification of pathogenic bacteria and the detection of drug sensitivity were carried out by using the Mellier identification and drug sensitivity detection system of France.Results Among 112 strains of pathogenic bacteria,Gram-negative bacilli accounted for 75.89%.The main pathogens were Acinetobacter baumannii,Pseudomonas aeruginosa,Klebsiella pneumoniae,eosinophils.Gram-positive bacteria accounted for 16%,mainly Staphylococcus aureus.Fungi accounted for 11%,mainly Candida albicans.Acinetobacter baumannii and Pseudomonas aeruginosa had severe multidrug resistance.Acinetobacter baumannii were more resistant to cephalosporins, penicillin, quinolones and carbapenes than 50%. The resistance rate of Pseudomonas aeruginosa to ampicillin / sulbactam was 100%.Conclusion The rate of multidrug resistance or pan-resistance of pathogenic bacteria of ventilator associated pneumonia is high.According to the data of drug resistance monitoring of bacteria,the antibiotics should be used reasonably in clinic.