ICU呼吸机相关性肺炎病原菌的分布及耐药监测临床分析

目的明确ICU呼吸机相关性肺炎(VAP)病原菌的分布特点及耐药性,指导合理用药。方法回顾性分析120例已确诊VAP患者的下呼吸道分泌物的病原菌及药敏结果。结果 120例VAP患者培养出病原菌296株,革兰阴性杆菌占63.85%,革兰阳性球菌占22.30%,真菌感染13.85%;各类病原菌混合感染者占87.10%;铜绿假单胞菌、鲍曼不动杆菌、肺炎克雷伯菌、大肠埃希菌均有出现多重耐药;金黄色葡萄球菌耐药现象严重,但仍对万古霉素敏感;抗真菌药物仍然敏感,但真菌感染发生率不可忽视。结论 VAP的主要病原菌为革兰阴性杆菌且存在较严重的耐药现象,混合感染现象严重;致病菌耐药性升高,临床上应加强抗生素的合理。。

Clinical Analysis of the Pathogens and Drug Resistance of Ventilator Associated Pneumonia in ICU

Objective To investigate the distribution and drug resistance characteristic of pathogens in patients with ventilator-associated pneumonia（VAP） in intensive care unite（ICU）,and to guide clinical rational use of drugs.Methods A retrospective analysis of the pathogens and drug sensitivity results was made in lower respiratory tract secretion of 120 patients with VAP in ICU.Results Among 296 strains of pathogens collected in VAP,the Gram-negative bacilli（GNB） occupied 63.65%,the Gram-positive bacteria（GPB） were 22.30%,and the fungal were 13.85%.The mixed infections attained to 87.10%.There are multiple drug resistance in Pseudomonas aeruginosa,Acinetobacter baumannii,Klebsiella pneumonia,Escherichia coli.Staphylococcus aureus was drug resistance severe,but was still highly susceptible to vancomycin.Fungal infection was a unneglectable part in VAP.Conclusion GNB are still the most important pathogens in VAP and have multiple drug resistance infections,Mixed infections are severe,bacterial culture and antibiotic susceptibility tests are very important to select antibiotics correctly for treatment of VAP.