机械通气相关肺部感染的病原菌调查及耐药性分析

目的调查重症监护病房（ICU）机械通气相关肺部感染的病原菌并分析其耐药性。方法对2006～2007年ICU62例机械通气相关肺部感染患者的下呼吸道标本分离出的致病菌进行鉴定及药敏试验。结果共检出致病菌89株，其中革兰阴性菌占74．2％（66株），革兰阳性菌占19．1％（17株），念珠菌占6．7％（6株）。检出耐甲氧西林金黄色葡萄球菌10株（83．3％），产超广谱肛内酰胺酶菌9株（42．9％）。结论ICU使用呼吸机易引起医院内肺部感染，感染的病原菌以铜绿假单胞菌和金黄色葡萄球菌为主。药敏结果显示细菌的耐药情况严重，应引起重视。

Analysis of pathogenic bacteria and their drug resistance in mechanical ventilator associated pulmonary infection

Objective To investigate the pathogenic bacteria and their drug resistance in mechanical ventilator associated pulmonary infection occurring in respiratory intensive care unit （RICU） and to analysis their drug resistance. Methods Pathogenic bacteria isolated from 62 cases of lower respiratory tract samples in patients with mechanical ventilator associated pulmonary infection in RICU from 2006 to 2007 were subjected to strain identification and drug sensitive test. Results 89 strains of pathogenic bacteria were identified by bacterial culture. Among those identified, gram negative bacteria accounted for 74.2 % （66/89）, gram positive bacteria 19.1% （17/89）, and Candida 6.7 % （6/89）. 10 strains （83.3 %） of MRSA and 9 ESBLs positive strains （42.9 %） were detected. Conclusion The patients receiving mechanical ventilator therapy in ICU are susceptible to hospital-acquired pulmonary infection. The pathogenic bacteria are mainly Pseudomonas aeruginosa and Staphylococcus aureus.