ICU呼吸机相关性肺炎的病原菌分布及多重耐药性分析

目的探讨ICU呼吸机相关性肺炎（ventilator—associatedpneumonia，VAP）的病原菌分布及多重耐药性。方法回顾性分析我院2007年8月～2010年6月ICU病房54例VAP患者的临床资料，了解其病原菌的构成及其药物敏感性。结果共检出病原菌87株，其中革兰阴性（G）杆菌占67．8％，革兰阳性（G^＋）球菌占23．0％，真菌占9．2％。铜绿假单胞杆菌最多（31．0％），其次为金黄色葡萄球菌（16．1％）和不动杆菌（14．9％）。G杆菌对碳青霉烯类抗生素的耐药性较低（〈12％）；G^＋球菌中，未发现耐利奈唑胺和万古霉素的葡萄球菌。结论ICU呼吸机相关性肺炎以G^-杆菌为主，且呈多重耐药性，临床应重视病原菌的检测及敏感抗生素的使用。

The Research of Pathogenic Bacteria Distribution and Multi-drug Resistance of Ventilator-associated Pneumonia in ICU

Objective To investigate the pathogenic bacteria distribution and multi-drug resistance of ventilator-associated pneumonia （ VAP ） in intensive care unit （ ICU ）. Methods 54 cases of VAP in our hospital from 2007 to 2010 were analyzed retrospectively; the pathogens and antimicrobial susceptibility were detected. Results Among 87 strains of isolated pathogens, the gram-negative bacteria accounted for 67.8%, the gram-positive bacteria for 23.0%, and the fungi for 9.2%. The isolating rate of Pseudomonas aeruginosa was the highest 31.0% and then was Staphylococcus aurous and Acinetobacter （ each for 16.1% and 14.9% ）. Gram-negative bacillus showed low resistance to Carbopenems （ 〈 12% ）. Gram-positive coccobacteria was not found the strains can revisited the Vancomycin and Linezolid. Conclusion Gram-negative bacteria were the majority of the pathogens isolated from patients with ventilator-associated pneumonia in ICU. Clinical doctors should think highly of pathogen detection and rational application of antibiotics.