呼吸机相关性肺炎的病原菌分布及其耐药性  

The Research of Pathogenic Bacteria Distribution Their Drug Tolerance in Ventilator-Associated Pneumonia

作　　者：王焱[1] 岳启安[1] 王彦芳[1] 金光香[1] 刘子骥[1] 

机构地区：[1]潍坊医学院病原生物学教研室,山东潍坊261053

出　　处：《潍坊医学院学报》2009年第5期340-343,共4页Acta Academiae Medicinae Weifang

摘　　要：目的了解重症监护病房内呼吸机相关性肺炎的病原菌分布及其耐药性,为临床防治提供依据。方法对67例呼吸机相关性肺炎(ventilator-associated pneumonia,VAP)患者的临床资料及病原菌的分布与耐药性进行回顾性研究与统计学分析。结果 189例插管患者中67例(35.45%)发生VAP,致死率为22.37%.VAP患病率与插管时间密切相关,病原菌分布以革兰阴性杆菌为主(87.29%),革兰阳性球菌占12.71%.革兰阴性杆菌对大多数临床常用抗生素耐药,革兰阳性球菌中未发现对万古霉素、替考拉宁耐药的菌株。结论应加强对机械通气患者下呼吸道病原菌的监测,采取多种防控措施,合理使用抗生素。Objective To study the pathogenic bacteria distribution and their drug tolerance in ventilator-associated pneumonia （ VAP） in intensive-care unit （ICU） so as to provide evidence for clinical prevention and treatment. Methods The clinical data, pathogenic bacteria distribution and antibiotics-sensitivity results of 67 patients with VAP were analyzed retrospectively. Results In one hundred and eighty-nine patients received mechanical ventilation （ 〉 48h） ,67 cases（35.45% ） developed VAP and the fatality rate was 22.37% ;The prevalence of VAP closely related to the intubation duration. In pathogenic bacteria distribution,gram-negative bacteria accounted for 87.29% and gram-positive bacteria accounted for 12.71%. Gram-negative bacteria are resist to majority of frequently used antibiotics in clinic. The strains in gram-positive bacteria resisted to Vancomycin and Teicoplanin was not found. Conclusion It is important to monitor the pathogenic bacteria in lower respiratory tract for the mechanical ventilation patients. Many prevention and control measures should be adopted and antibiotic in rational use.

关 键 词：呼吸机 肺炎 病原菌 耐药性 

分 类 号：R563.1[医药卫生—呼吸系统]