呼吸监护室呼吸机相关性肺炎病原菌变迁及其影响因素分析  

Changing characteristics and associated factors of microbial pathogens in ventilator-associated pneumonia in respiratory care unit

作　　者：唐一杰[1] 

机构地区：[1]华北电网有限公司北京电力医院呼吸内科,100053

出　　处：《国际呼吸杂志》2012年第10期721-724,共4页International Journal of Respiration

摘　　要：目的了解华北电网有限公司北京电力医院（简称本院）呼吸监护室呼吸机相关性肺炎（VAP）病原菌的变迁特点及影响因素。方法回顾性分析了2005年至2011年9月在本院呼吸监护室进行有创机械通气并发生VAP的患者共79例。使用SPSS软件17．0分析数据，描述病原菌变化特点，应用x^2检难比较各年份之间、各年龄组之间以及基础病不同的患者之间VAP病原菌变化是否有意义，应用秩相关分析说明病原菌变化与年龄的相关关系。结果7年间检出病原菌前5位的分别是：铜绿假单胞菌（23．2％）、鲍曼不动杆菌（15．9％）、耐甲氧西林金黄色葡萄球菌（13．2％）、大肠埃希杆菌（11．3％）、嗜麦芽窄食单胞菌（8．6％）；各年份之间、年龄组之间以及不同用药组之间病原菌分布有统计学差异。结论7年来本院呼吸监护室VAP患者鲍曼不动杆菌以及耐甲氧西林金黄色葡萄球菌感染率明显增加，病原菌的分布可能与患者住院时间、年龄、抗生素的使用有关。Objective To investigate the changing characteristics and associated factors of pathogens which caused ventilator-associated pneumonia （VAP） in the respiratory care unit. Methods A retrospective analyses was used to investigate 79 cases of VAP in the respiratory care unit from 2005 to September 2011. The data were analyzed using SPSS 17.0 software,and x^2 -test was used for the analysis of variance comparison of the distribution and changing of VAP pathogens among different years,different age groups and patients with different underlying diseases. Rank correlation analysis was used to describe the correlation between pathogen change and age. Results Among the seven years, the top five for the detection of pathogens were Pseudomonas aeruginosa （23.2%）, Acinetobacter baumannii （ 15.9%）, methicillin-resistant Staphylococcus aureus （ 13.2 %）, Escherichia bacilli （ 11.3 %）, Stenotrophomonas narrow food Aeromonas （8.6%）. Differences in the distribution of pathogens among different years, different age groups, and different treatment groups were statistically significant. Conclusions In the recent seven years, the incidence of VAP caused by Acinetobacter baumannii and methicillin resistant Staphylococcus aureus in the respiratory care unit increases significantly, the distribution of pathogens may be associated with hospitalization time,age of the patients,and the use of antibiotics.

关 键 词：呼吸监护室 呼吸机相关性肺炎 病原菌 

分 类 号：R446.5[医药卫生—诊断学]