25例儿童呼吸机相关性肺炎的临床分析

目的 探讨儿童呼吸机相关性肺炎(VAP)的主要病原菌,指导临床治疗和预防.方法 对2005年1月一2010年11月在儿科住院的25例机械通气＞48 h的患儿作气道分泌物病原菌培养,同时作药敏试验.结果 分离出病原菌28株,其中革兰阴性菌16株,占57.1％,依次为肺炎克雷伯菌、铜绿假单胞菌、嗜麦芽寡养单胞菌、鲍氏不动秆菌；革兰阳性球菌10株,占35.B％,分别为溶血葡萄球菌、口腔链球菌；真菌2株,占7.1％.结论 VAP 的病原菌以革兰阴性菌为主,革兰阳性球菌、真菌也不容忽视；根据药敏合理选用抗菌药物,避免滥用抗菌药物.

Clinical analysis of ventilator-associated pneumonia in 25 children

OBJECTIVE To investigate the major pathogens causing ventilator-associated pneumonia(VAP) in children and provide basis for the clinical treatment and prevention.METHODS The bacterial culture of airway secretions from 25 pediatric patients who underwent mechanical ventilation for more than 48h from Jan.2005 to Nov.2010 was performed,the drug susceptibility testing was conducted at the same time.RESULTS Among 28 strains of pathogens isolated,there were 16(57.1%) strains of gram-negative bacteria including Acinetobacter baumannii.Klebsiella pneumonia,Pseudomonas aeruginosa,and Stenotrophomonas maltophilia;there were 10(35.8%) strains of gram-positive cocci including Staphylococcus haemolyticus and Streptococcus oralis;and there were 2 strains of fungi,accounting for 7.1%.CONCLUSION The major pathogens causing VAP were gram-negative bacteria,and gram-positive bacteria and fungi should not be disregarded.The antibiotics should be reasonably selected based on the drug susceptibility testing to avoid the abuse of antibiotics.