ICU呼吸机相关肺炎的流行病学调查及临床防治分析

目的：了解呼吸机相关肺炎（VAP）的病原菌及其药敏情况，。方法：对深圳市人民医院ICU46例VAP患者的痰培养及药敏结果进行回顾性分析。结果：本组VAP患者的细菌学培养83．4％为G^-杆菌，其中以铜绿假单胞菌、嗜麦芽假单胞菌和不动杆菌菌最为常见，药敏试验显示VAP对环丙沙星、丁胺卡那、氧哌嗪青霉素、特美汀及头胞他淀有较好的敏感性，而对依米配能的耐药性提高。结论：必须加强ICU机械通气患者下呼吸道细菌的检测，采取多种防治措施，在治疗VAP时应根据药敏结果合理使用抗生素。

Epidemiology and prevention of ventilator-associated pneumonia in intensive-care unit

Objective To study the pathogenic bacteria and their antibiotics sensitivity of ventilator associated pneumonia(VAP) in intensive care unit. Methods The retrospective analysis was performed in the sputum cultures and antibiotics sensitivity results of 46 cases of VAP registered in ICU of Shenzhen People's Hospital. Results 83.4% of sputum culture Resutls were gram negative bacilli, most of which were Pseudomonas aeruginosa, Pseudomonas maltophilia and Acinetobacter. The cultures were highly sensitive to cirprofloxacin, kanamycin, piperacillin, Timentin and ceftazidime, but there was increased drug resistance of isolated bacteria to imipenem. Conclusions Mechanical ventilated patients in ICU must receive low respiratory tract bacteria monitor, and multiple prevention strategy shoud be adopted. Antibiotics should rationally be used according to the results of antimicrobial susceptibility tests during VAP therapy.