衢州市呼吸机相关性重症肺部感染病原学分布及耐药性探讨

目的 探讨衢州市呼吸机相关性重症肺部感染病原学分布及耐药性。方法 选取2017年5月～2018年5月入住衢州市医院重症监护病房的呼吸机相关性肺炎患者102例,观察患者病原学分布并分析其耐药性。结果102例呼吸机相关性重症肺炎患者中共分离140株病原菌,期中包括7株(5.0%)真菌、35株(25.0%)革兰氏阳性球菌以及98株(70.0%)革兰氏阴性杆菌,在革兰氏阴性杆菌中的铜绿假单胞菌及肺炎克雷伯菌对复方新诺明、环丙沙星、左氧氟沙星以及庆大霉素的耐药率较高,在革兰氏阳性球菌中的金黄色葡萄球菌对舒巴坦、环丙沙星、哌拉西林、左氧氟沙星、庆大霉素、阿米卡星、头孢他啶、头孢曲松、头孢唑啉以及头孢吡肟的耐药率较高。结论呼吸机相关性重症肺部感染患者的病原学分布主要为革兰氏阴性菌,且具有多重耐药的特性,应以其耐药性为基础,合理应用药物,确保疗效。

Pathogenic distribution and drug resistance of severe pulmonary infection associated with ventilator in Quzhou city

Objective To investigate the pathogenic distribution and drug resistance of severe pulmonary infection associated with ventilator in Quzhou city.Methods A total of 102 patients with ventilator-associated pneumonia admitted to the intensive care unit of Quzhou city from May 2017 to May 2018 were enrolled.The pathogen distribution was observed and the drug resistance was analyzed.Results A total of 140 pathogens were isolated from 102 patients with severe ventilator-associated pneumonia,including 7(5.0%) fungi,35(25.0%) gram-positive cocci and 98 (70.0%) gramnegative bacilli.Pseudomonas aeruginosa and klebsiella pneumoniae in gram-negative bacilli were highly resistant to cotrimoxazole,ciprofloxacin,levofloxacin and gentamicin.In gram-positive cocci,staphylococcus aureus had higher resistance rates to sulbactam,ciprofloxacin,piperacillin,levofloxacin,gentamicin,amikacin,ceftazidime,ceftriaxone,cefazolin and cefepime.Conclusion The etiology of ventilator-associated severe pulmonary infection is mainly gram-negative bacteria,and has multi-drug resistance.Clinically,drugs should be rationally used based on its drug resistance to ensure clinical efficacy.