呼吸机相关性肺炎病原菌谱文献分析  

Analysis of spectrum of pathogens causing ventilator-associated pneumonia through review of literature

作　　者：王林峰[1] 王选锭[2] 黄小萍[1] 胡丽庆[1] 

机构地区：[1]宁波市第一医院呼吸科,浙江宁波315000 [2]浙江大学医学院附属第二医院感染管理科,浙江杭州310000

出　　处：《中华医院感染学杂志》2013年第10期2478-2480,共3页Chinese Journal of Nosocomiology

基　　金：浙江省医药卫生科学研究基金资助项目(2011KYB099)

摘　　要：目的研究呼吸机相关性肺炎(VAP)病原谱,早发性VAP与晚发性VAP病原谱差异及其他临床流行病学情况,为治疗提供参考。方法检索维普中刊数据库中发表的有关VAP临床论文进行统计分析。结果共检索到文献2743篇,其中共18篇进入统计分析,18篇均可用于病原学统计,共检出病原菌3347株,其中革兰阴性杆菌为2457株占73.4%,革兰阳性球菌555株占16.6%,真菌335株占10.0%;可用于早发性VAP与晚发性VAP病原谱比较的共3篇,统计出铜绿假单胞菌、洋葱假单胞菌以及真菌的构成比稍有差异(P<0.05),其余病原菌构成比差异无统计学意义;可用于发病率统计的共9篇,统计出发病率为41.6%;可用于病死率统计的共10篇,统计出病死率为25.0%。结论文献分析显示,VAP病原谱以革兰阴性杆菌为主,早发性VAP与晚发性VAP病原谱差异不大。OBJECTIVE To study the distribution of pathogens causing ventilator-associated pneumonia（VAP）, to differentiate the spectrum of pathogens causing early-onset VAP from the spectrum of pathogens causing late-onset VAP and to explore other clinical epidemics so as to provide basis for the clinical treatment. METHODS The clinical papers about VAP published by VIP Information＇s Chinese Scientific Journals Database were retrieved and statistically analyzed. RESULTS Totally 2743 articles were retrieved, and 18 articles were selected for the statistical analysis, all the 18 articles were suitable for the etiological analysis. A total of 3347 strains of pathogens were isolated,including 2457 （73.4%） strains of gram-negative bacilli, 555 （16.6%） strains of gram-positive cocci,and 335 （10. 0%） strains of fungi. Totally 3 articles were suitable for the comparison of the spectrum between the pathogens causing early-onset VAP and the pathogens causing late-onset VAP, the statistical analysis indicated that the difference in the distribution of the Pseudomonas aeruglnosa, Burkholeria cepaci or the fungi was statistically significant（P〈0.05）, while the difference in the distribution of the rest of pathogens was not statistically significant; totally 9 articles were suitable for the statistical analysis of the incidence of disease which concluded that the incidence was 41. 6%; totally 10 articles were suitable for the statistical analysis of the mortality which revealed that the mortality was 25.0 %. CONCLUSION The analysis of the literature indicates that the gram-negative bacilli are the predominant pathogens, there is little difference between the spectrums of the pathogens causing early-onset VAP and the pathogens causing late-onset VAP.

关 键 词：呼吸机相关性肺炎 文献分析 病原谱 发病率 病死率 

分 类 号：R563.1[医药卫生—呼吸系统]