铜绿假单胞菌致呼吸机相关性肺炎的临床分析  

Clinical analysis of pseudomonas aeruginosa-induced ventilator-associated pneumonia

作　　者：王昌明[1] 王晨[1] 何宗广[1] 肖爱兵 俞莲花[2] 

机构地区：[1]台州市立医院ICU,浙江台州318000 [2]台州市立医院细菌室,浙江台州318000

出　　处：《中华医院感染学杂志》2011年第2期376-378,共3页Chinese Journal of Nosocomiology

摘　　要：目的为防治铜绿假单胞菌(PAE)致呼吸机相关性肺炎(VAP)提供科学依据。方法回顾性分析医院ICU 2004年1月-2008年12月,86例铜绿假单胞菌致VAP的住院患者的临床资料及药敏情况。结果铜绿假单胞菌所致VAP均有较严重的基础疾病,老年患者占79.1%,发病前均曾使用过≥1种抗菌药物,33.7%有混合感染;铜绿假单胞菌有多药耐药性,临床分离的铜绿假单胞菌共128株,耐药率依次为:阿米卡星23.4%,头孢哌酮/舒巴坦25.0%,亚胺培南34.4%,环丙沙星35.2%,哌拉西林/他唑巴坦37.5%,头孢噻肟40.6%,头孢他啶42.2%,氨曲南59.4%。结论应根据该地区、医院铜绿假单胞菌致VAP的病原学分布特点及药敏情况,合理选择抗菌药物。OBJECTIVE To explore the ventilator-associated pneumonia caused by Pseudomonas aeruginosa,and to provide the corresponding measures for clinical prevention.METHODS The clinical records and sputum cultivation bacterial susceptibility of 86 cases of VAP caused by P.aeruginosa between 2004 and 2008 in ICU of our hospital were reviewed.RESULTS All of the patients suffered from severe basic diseases.the aged accounted for 79.1%,at least one kind of antibiotic was used in all cases before occurrence of VAP.33.7% of the cases had mixed infections.The results of bacterial susceptibility tests showed that P.aeruginosa had multiple drug resistance,A total of 128 clinical isolates of P.aeruginosa were collected.The resistant rates of P.aeruginosa to antimicrobial agents from low to high were amikacin（23.4%）,cefoperazone/sulbactam（25.0%）,imipenem（34.4%）,ciprofloxacin（35.2%）,piperacillin/tazobactam（37.5%）,cefotaxime（40.6%）,ceftazidime（42.2%） and aztreonam（59.4%）.CONCLUSION The antibiotics to treat VAP caused by P.aeruginosa should be rationally selected based on the latest surveillance of etiology and drug sensitivity in this region.

关 键 词：铜绿假单胞菌 呼吸机相关性肺炎 耐药性 

分 类 号：R378[医药卫生—病原生物学]