重症监护病房呼吸机相关性肺炎病原菌分布与耐药性分析

目的：调查重症监护病房（ICU）应用人工气道进行机械通气的患者伴呼吸机相关性肺炎的致病菌群及药敏情况。方法：对185例建立人工气道的机械通气伴呼吸机相关性肺炎的患者痰培养分离出的229株致病菌进行药敏试验。结果：革兰阳性菌占27.9%。革兰阴性菌占72.1%,分别列前3位的是铜绿假单胞菌（26.1%）、鲍氏不动杆菌（21.2%）、嗜麦芽寡养单胞菌（9.6%）。药敏结果表明：所有革兰阴性菌对抗菌药物的耐药率呈上升趋势。结论：呼吸机相关性肺炎的病原菌仍以革兰阴性菌为主,为避免耐药率的升高,临床需要合理使用抗生素。

Distribution and resistance of ventilator-associated pneumonia pathogenic bacteria in ICU

Objective：To investigate the distribution and sensitivity of pathogenic bacteria in ventilator-associated pneumonia （VAP） in ICU. Methods：We isolated 229 strains of pathogens from 185 patients who underwent mechanical ventilation by artificial airway with VAP in ICU to perform drug susceptibility test. Resul ts：Sixty-four of 187 strains showed gram-positive bacilli （27. 9%） and 165 of 229 strains showed gramnegative bacilli （72. 1%）. The first three were pseudomonas aeruginosa （26. 1%）, aeinetobaeter baumanii （21.1%） and stenotrophomonas mahophilia （9.6%）. The drug sensitivity test revealed that the drug resistance rate showed an increasing tendency in gram-negative bacilli. Conclusion.The gram-negative bacilli are the main pathogens in ventilator-associated pneumonia. In order to control the drug resistance, the reasonable application of antibiotics should be emphasized.