综合ICU呼吸机相关肺炎主要病原菌及其耐药性分析

目的 探讨综合ICU病房呼吸机相关性肺炎(VAP)的主要病原菌及其耐药性,为临床防治提供科学依据.方法 回顾分析本院2013年1月至2015年12月ICU病房100例VAP患者下呼吸道分泌物细菌培养及药敏结果.结果 100例VAP患者下呼吸道分泌物中共分离出病原菌112株,其中革兰阴性菌96株占85.7％,革兰阳性菌13株占11.6％,真菌3株占2.7％;排前3位病原菌依次为鲍曼不动杆菌、铜绿假单胞菌、肺炎克雷伯菌,分别占22.3％、19.6％、13.4％;抗菌药物中,三种菌均对亚胺培南敏感,鲍曼不动杆菌对头孢哌酮/舒巴坦敏感,铜绿假单胞菌对哌拉西林/他唑巴坦、头孢哌酮/舒巴坦较敏感;肺炎克雷伯菌对孢哌酮/舒巴坦较敏感.结论 该结果对指导临床预防VAP发生,合理选用抗菌药物有重要的参考价值.

Main patenogens and their drug resistance in patients with ventilator associated pneumonia at ICU

Objective To investigate the main pathogens and their drug resistance of ventilator associated pneumonia (VAP) at comprehensive ICU and to provide scientific references for clinical prevention and treatment.Methods The results of the bacterial culture of lower respiratory tract secretions and drug sensitivity test in 100 patient with VAP treated at our hospital from January,2013 to December,2015 were retrospectively analyzed.Results 112 strains of pathogens were isolated from the lower respiratory tract secretions in the 100 patients with VAP;among which,96 strains (85.7％) were Gram-negative bacilli,13 strains (11.6％) grampositive bacteria,and 3 strains (2.7％) fungi.The top three pathogens were acinetobacter baumannii,pseudomonas aeruginosa,and klebsiella pneumonia,accounting for 22.3％,19.6％,and 13.4％,respectively.Those three kinds of bacteria were sensitive to imipenem;acinetobacter baumannii was sensitive to Cefoperazone/sulbactam;pseudomonas aeruginosa was sensitive to piperacillin/tazobactam and Cefoperazone/sulbactam;and klebsiella pneumonia was sensitive to Cefoperazone/sulbactam.Conclusions This result has important reference value for guiding the clinical prevention of VAP and the rational selection of antibiotics.