综合ICU晚发性呼吸机相关性肺炎细菌学耐药性的调查研究  

Pathogens of tardive Ventilator-associated pneumoniain in comprehensive ICU and the drug resistance thereof

作　　者：刘德新[1] 王育珊[1] 田加坤[1] 

机构地区：[1]吉林大学第二医院急救医学科/急救医学教研室,吉林130041

出　　处：《中国急救复苏与灾害医学杂志》2006年第6期215-217,共3页China Journal of Emergency Resuscitation and Disaster Medicine

摘　　要：目的调查综合性ICU晚发性呼吸机相关性肺炎(VAP)的病原菌及其耐药性,为防治晚发性VAP提供依据。方法对综合性ICU收治的67名机械通气患者痰液进行常规培养、分离致病菌及药敏试验,以机械通气超过5d为限分为非VAP组及晚发性VAP组两组,对临床资料和微生物资料进行回顾性分析,调查晚发性VAP患者的病原菌分布及耐药性。结果晚发性VAP组共分离出病原菌116株,病原菌以G-菌为主,占菌株总数的75.0%;G+菌占菌株总数的6.03%;真菌占菌株总数的18.97%。G-菌主要是铜绿假单胞菌、鲍曼不动杆菌、肺炎克雷伯菌。G+菌主要以金黄色葡萄球菌为主要致病菌。结论G-杆菌为晚发性VAP的优势菌群,大多数G-菌对常用的抗菌药物具有较高的耐药性。Objective To investigate the of tardive ventilator-associated pneumonia inn(VAP)in comprehensive ICU and the drug resistance thereof,so as to help develop clinical prevention strategies.Methods Sixty-seven patients admitted in ICU underwent tracheal intubation and tracheotomy,and mechanical ventilation.Pneumonia occurring 5 days after the mechanical ventilation was regarded as VAP.Sputum suction tube was used to collect the secretion from the lower respiratory tract to undergo culture of pathogens.Drug resistance test was conducted on the pathogens.Results Of the pathogens 75.00% were Gram-negative bacilli,6.03% were Gram-positive bacilli,and 18.97% were eumycetes.The commonest bacilli were Pseudomonas aeruginosa,Acinetobacter baumanii,Klebsiella pneumoniae,Staphylococcus aureus,and Candida albican.These pathogens were resistant to most commonly used antibiotics.Conclusion Gram-negative bacilli are the dominant pathogens of VAP separated from the patients receiving mechanical ventilation in comprehensive ICU,and these pathogens show high drug-resistance rates to commonly used antibiotics.

关 键 词：晚发性呼吸机相关性肺炎 ICU 病原菌 耐药性 

分 类 号：R[医药卫生]