COPD并发呼吸机相关肺炎的病原学分析

目的：分析慢性阻塞性肺病（COPD）有创机械通气并发呼吸机相肺炎（VAP）的病原以及药敏情况。方法：回顾分析年来本院肺科重症监护病房（RICU）内收治的28例VAP患者的临床资料、病原菌构成以及药敏结果。结果VAP的发生率为66．7％，共培养出细菌91株，真菌10株，其中革兰氏阴性杆菌（GNB）64株（70．3％），革兰氏阴性球菌（GPC）27 株（29．7％）。COPD并发VAP居首位的细菌是嗜麦芽穿食单孢菌。结论COPD有效机械通气并发VAP以及GNB为主，VAP发生后细菌的耐药率普遍较高。在治疗VAP时应重视病原菌培养和药敏试验结果，合理应用抗生素。

Aetiological Analysis of Chronic Obstructive Pulmonary Disease Complicated with Ventilator-associated Pneumonia

Objective To analyze the aetiological characteristics and bacterial susceptibility in chronic obstructive pulmonary disease (COPD) complicated with ventilator-associated pneumonia (VAP) after mechanical ventilation. To review the clinical characteristics, aetiological flora and bacterial susceptibility in 28 patients complicated with VAP in the ICU in recent years. The incidence rate of VAP was 66.7%. 91 clinical bacteria and 10 mycete isolates were collected, 64(80.3%) were Gram-negative bacteria (GNB) and 27(29.7%) Gram-positive bacteria (GPC). The dominant bacteria was Xanthomonas maltophilia in COPD complicated VAP. The main kind of bacteria in COPD complicated VAP after mechanical ventilation was GNB, and all kinds of the bacteria showed high tolerance. More attention should be paid to the cultivate aetiological bacteria and bacterial susceptibility and select the most suitable antibiotics in the treatment of VAP.