ICU呼吸机相关性肺炎的病原学及耐药性监测分析  

Etiology and drug resistance monitoring analysis of ventilator-associated pneumonia in ICUs

作　　者：刘竹[1] 安寒[1] 黄琼华[2] 李俪华 邓小华[1] 刘洪[4] 

机构地区：[1]成都市疾病预防控制中心,四川成都610041 [2]双流县第一人民医院院感科,四川成都610200 [3]三六三医院院感科,四川成都610041 [4]成都医学院,四川成都610083

出　　处：《现代预防医学》2014年第18期3418-3420,共3页Modern Preventive Medicine

摘　　要：目的分析呼吸机相关性肺炎的病原体分布及耐药情况,以指导临床合理用药。方法收集84例ICU中呼吸机相关患者的痰标本进行病原体培养,并对致病菌进行药敏试验。结果共检出病原菌154株,其中革兰阴性菌133株,占86.4%,革兰阳性菌16株,占10.4%,真菌5株,占3.2%;前5位致病菌为:洋葱伯克霍尔德菌、肺炎克雷伯菌、鲍曼不动杆菌、铜绿假单胞菌、金黄色葡萄球菌。所检出的病原体药敏试验均呈现多重耐药性。结论 ICU呼吸机相关肺炎的主要病原体为革兰阴性菌,且均为多重耐药菌,提示临床应加强抗生素合理使用。Objective The study aimed to analyze the distribution of pathogens and drug resistance of ventilator-associated pneumonia, so to provide guidance on the rational use of antibiotics. Methods Sputum specimens of 84 ICU patients with pneumonia were collected for cultivation of pathogens, which were then tested for their drug sensitivity A total of 154 strains of pathogens were detected, with 133 strains of gram-negative bacteria （86.4%）, 16 strains ofgram-positive bacteria （10.4%）, and 5 strains of fungi （3.2%）. The five most prevalent pathogens were Burkhotaerta cepacta, KlebsieUa pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Staphylococcus aureus. Drug sensitivity tests indicated multi-drug resistance of all the isolated pathogens. Conclusion Gram-negative bacteria are the main pathogen for ventilator-associated pneumonia in ICUs and exhibits multi-drug resistance, suggesting that the rational use of antibiotics should be reinforced.

关 键 词：呼吸机相关肺炎 病原体 耐药 

分 类 号：R563[医药卫生—呼吸系统]