重症监护病房机械通气患者下呼吸道感染的病原菌及耐药性研究

目的 了解我院重症监护病房（ICU）机械通气并发下呼吸道感染的病原菌及其耐药性，为临床防治提供依据。方法 对110例ICU机械通气合并下呼吸道感染患者的发病年龄、基础疾病、病原菌构成及耐药率进行分析。结果共检出致病菌110株，其中革兰阴性菌（G^-）占72．7％（80株），革兰阳性菌（G^＋）占18．2％（19株）,真菌占10％（11株），其中铜绿假单胞菌居首位。产超广谱β-内酰胺酶（ESBLs）细菌分离率为38．8％，耐甲氧西林葡萄球菌（MRS）占葡萄球菌总数的31．6％。G^-杆菌的药敏结果显示多重耐药。结论 ICU机械通气引发下呼吸道医院感染病原体以G^-菌为主。临床应重视病原体的检查，开展细菌耐药性的监测，合理使用抗菌药物。

Pathogens and Drug Resistance of Lower Respiratory Tract Infection in Patients Receiving Mechanical Ventilation in ICU

OBJECTIVE To determine pathogens and drug resistance of lower respiratory tract infection in patients receiving mechanical ventilation in ICU and to provide the reference for clinical prevention and treatment.(METHODS) The ages,underlying diseases,pathogens distribution and resistance rate of Gram-negative bacteria of 110 cases patients receiving mechanical ventilation and being complicated lower respiratory tract infection in ICU were investigated.RESULTS Totally 110 strains of pathogens were isolated by bacterial culturing.The ratio of the Gram-negative bacteria to total bacteria isolated was 72.7%(80 strains) and of the Gram-positive bacteria was(18.2%)(19 strains),of the fungi was 10%(11 strains),among them the Pseudomonas aeruginosa contributed the majority,and ESBLs accounted for 38.8%,MRSA contributed 31.6% in Staphylococcus.Multidrug-(resistance) of Gram-negative bacteria to antimicrobial agents was serious.CONCLUSIONS Gram-negative bacteria are the majority of the pathogens,isolated from patients with lower respiratory tract infection in ICU receiving mechanical ventilation.It is suggested that there be urgent need for surveillance of bacterial resistance and rational use of antimicrobial(agents) during clinical therapy.