ICU呼吸机相关肺炎病原菌分析及临床策略

目的分析呼吸机相关肺炎（VAP）病原菌构成及耐药情况及临床处理对策。方法回顾分析2007年12月至2009年7月ICUVAP患者57例痰培养的病原菌及药敏结果。结果VAP发生率为54．9％，培养出细菌92株，真菌25株；其中革兰氏阴性杆菌82株，革兰氏阳性杆菌10株。其中肺炎克雷伯杆菌8株，白色念珠菌16株，铜绿假单胞菌65株。结论VAP感染以革兰氏阴性杆菌为主，耐药率普遍较高，应根据病原学分析，合理应用抗生素。

Aetiological analysis and clinical tactics of Ventilator-associated-pneumonia in ICU

Objective To analyze the aetiological characteristics and bacterial susceptibility in patients with -pneumonia（VAP） and clinical measures. Methods To review the clinical characterkisics, aetiological flora and bacteria susceotibility in 57 patients with VAP in ICU. Results 92 bacteria and 25 mycete were isolated. Among which 82 were Gram-negative bacteria（GNB） and 10 were Gram-positive bacteria. Kleb- siella pneumoniae 8 strain, moniliasia 16 strains. Pseudomonas aemginosa 65strain. Conclusion The domiant bacterium in patients with VAP was GNB,and all bacteria showed high ressitance to common antibiotics, clinical tactics emphasis select suitable antibiotics on the basis of aetiological analysis and integrated control.