小儿呼吸机相关性肺炎非发酵菌感染分析  

Non-fermentative bacteria causing infection in pediatrics with ventilator-associated pneumonia

作　　者：王霞[1] 

机构地区：[1]宁波市妇女儿童医院医院感染管理科,浙江宁波315010

出　　处：《中华医院感染学杂志》2011年第9期1921-1923,共3页Chinese Journal of Nosocomiology

摘　　要：目的探讨非发酵菌在小儿呼吸机相关性肺炎（VAP）的分布及耐药性,为VAP治疗提供参考。方法对医院小儿ICU 68例VAP患儿的下呼吸道分泌物进行细菌培养及抗菌药物敏感试验。结果 68例VAP患儿的下呼吸道分泌物分离出81株病原菌,革兰阴性杆菌69株,占85.2%,其中非发酵菌50株,占61.7%;前2位非发酵菌为鲍氏不动杆菌、嗜麦芽寡养单胞菌,分别占62.0%、20.0%,铜绿假单胞菌、脓毒脑膜黄杆菌、鲁氏不动杆菌并列第3,均占6.0%;不同非发酵菌对常用抗菌药物耐药率差异较大,为0~100.0%,仅对哌拉西林/他唑巴坦、环丙沙星耐药率〈10.0%。结论非发酵菌是小儿呼吸机相关性肺炎的最主要致病菌,初始经验性治疗可以优先考虑使用哌拉西林/他唑巴坦。OBJECTIVE To study the distribution of the non-fermentative bacteria infection in pediatrics with ventilator-associated pneumonia（VAP） and analyze antimicrobial resistance,and to provide reference for clinical treatment.METHODS Among 68 pediatrics with VAP in intensive care unit in hospital,the lower respiratory tract secretions were cultured and analyzed.RESULTS Among 81 strains of isolated pathogens in 68 patients,the Gram-negative bacteria accounted for 69 strains（85.2%）.Of which,50 strains（61.7%） were non-fermentative bacteria.The predominant non-fermentative bacteria were Acinetobacter baumannii（62.0%）,Stenotrophomonas maltophilia（20.0%）,Pseudomonas aeruginosa（6.0%）,Chrysebacterium meningosepticum（6.0%） and Acinetobacter lwoffi（6.0%）.Different non-fermenting bacteria to antimicrobial resistance rates vary widely（0-100%）.The resistance rates to piperacillin/tazobactam,ciprofloxacin were less than 10.0%.CONCLUSION Non-fermenting bacteria are predominant pathogens causing ventilator-associated pneumonia（VAP） in pediatrics.Piperacillin/tazobactam can be used as the initial empirical therapy for pediatrics with VAP.

关 键 词：小儿 呼吸机相关性肺炎 非发酵菌 耐药性 

分 类 号：R378[医药卫生—病原生物学]