呼吸机相关性肺炎病原菌分布及耐药性检测分析  

Pathogenic Bacteria Distribution and Drug Resistance in Ventilator-associated Pneumonia

作　　者：赵丽霞[1] 杨乐[1] 王家平[2] 宋舸[1] 

机构地区：[1]南京医科大学附属常州第二人民医院感染管理科,江苏常州213003 [2]南京医科大学附属常州第二人民医院微生物实验室,江苏常州213003

出　　处：《中华医院感染学杂志》2010年第23期3795-3797,共3页Chinese Journal of Nosocomiology

摘　　要：目的探讨ICU呼吸机相关性肺炎病原菌的分布及其耐药性,为临床防治提供依据。方法对2009年ICU呼吸机相关性肺炎患者下呼吸道痰液标本分离出的病原菌及其药敏试验结果进行回顾性调查分析。结果 ICU呼吸机相关性肺炎患者94株下呼吸道痰液标本检出病原菌中,革兰阴性菌75株(79.8%),以鲍氏不动杆菌(34.0%)和褪色沙雷菌(20.2%)为主;革兰阳性菌15株(16.0%),以金黄色葡萄球菌(9.6%)为主,全部为耐甲氧西林金黄色葡萄球菌;真菌4株(4.2%),全部为白色假丝酵母菌;药敏检测结果显示,革兰阴性菌均呈现多药耐药性。结论 ICU呼吸机相关性肺炎病原菌以革兰阴性菌为主且多药耐药,MRSA的感染率高,合理使用抗菌药物成为当务之急。OBJECTIVE To study the pathogenic bacteria distribution and the drug resistance in ventilator-associated pneumonia（VAP） in intensive-care unit（ICU） so as to provide evidence for clinical prevention and treatment.METHODS The distribution of isolated pathogenic bacteria and the drug sensitivity results of patients with VAP in ICU in 2009 were analyzed retrospectively.RESULTS Among 94 strains of sputum samples from respiratory tract,Gram-negative bacteria（75 strains） accounted for 79.8% and showed the multi-drug resistance,of which Acinetobacter baumannii（34.0%） and Serratia marcescens（20.2%） were common;Gram-positive bacteria（15 strains） accounted for 16.0%,the majority was Staphylococcus aureus（9.6%） and all were MRSA;fungi（4 strains） accounted for 4.2%,all were Candida albicans.CONCLUSION The Gram-negative bacteria is the majority of pathogenic bacteria in VAP in ICU and shows the multi-drug resistance.The infection rate of MRSA is high,and it is urgent to make the rational application of antibiotics.

关 键 词：重症监护病房 呼吸机相关性肺炎 病原菌 耐药性 

分 类 号：R378[医药卫生—病原生物学]