呼吸机相关性肺炎患者病原菌分布及耐药情况研究

目的探讨医院呼吸机相关性肺炎（VAP）病原菌分布及耐药情况，以便更好地指导临床用药。方法回顾性分析我院收治的598例机械通气患者的临床资料，从中筛选VAP患者并对其下呼吸道分泌物病原菌进行培养并鉴定结果。结果221例VAP患者下呼吸道痰液共分离出251株病原菌，其中革兰阴性菌与阳性菌分离率分别占71．3％与17．9％；革兰阴性菌与阳性菌分别以鲍曼不动杆菌与金黄色葡萄球菌分离率最高。鲍曼不动杆菌泛耐药菌株的检出率最高，达27．9％，MRSA和MRSE检出率分别为66．7％和61．5％。结论VAP的病原菌以革兰阴性菌为主，相关菌株耐药性逐渐增高，应及时监测相关病原菌耐药性。

Distribution and drug resistance of pathogens in patients with ventilatorassociated pneumonia

Objective To investigate the distribution and drug resistance pathogens from ventilator-associated pneumo- nia （VAP） patients for to better guide clinical treatment. Methods The medical records of 598 mechanical ventilation patients were retrospectively reviewed and the results of sputum culture and antibiotic resistance of pathogens from VAP patients were analyzed. Results The 251 strains of pathogens were isolated from lower respiratory tract sputum specimens in 221 patients with ventilator-associated pneumonia. Among them, the isolation rate of the gram-negative bacteria was the highest （71.3%）, followed by the gram-positive bacteria （17.9%）. The Acinetobaeter baumannii and Staphylococcus were the top species in gram-negative and gram-positive bacteria, respectively. The isolation rate of the pan-resistant for Acinetobacter baumannii was 27.9% and the isolation rate of methieillin-resistant Staphylococcus aureus （MRSA） and methicillin-resistant Staphylococcus epidermidis （MRSE） were 66.7% and 61.5%, respectively. Conclusion The gram-negative bacteria remain dominant in the pathogens causing VAP, and related strains are highly drug resistant. It is crucial for timely monitoring of drug resistance of the pathogens.