重症医学科呼吸机相关性肺炎病原学特征及耐药性分析  

Intensive medicine characteristics of ventilator associated pneumonia etiology and drug resistance analysis

作　　者：宋轶婷 郑翔[1] 盛春风[1] 

机构地区：[1]湖北医药学院附属太和医院重症医学科,湖北十堰442000

出　　处：《中医学报》2014年第B12期173-173,共1页Acta Chinese Medicine

摘　　要：目的研究重症医学科呼吸机相关性肺炎（VAP）病原菌特点及其耐药性.方法：回顾分析我院2011 年3 月至2013 年3 月期间ICU 接诊的40 例患者呼吸道分泌物培养及药物敏感试验结果,对比存活组与肺炎相关性死亡组的临床资料以及病原菌结构特点.结果：40 例肺炎患者中检出病原菌81 株,以G-菌为主（75.6%）,其中主要以铜绿假单胞菌（34 株）为主,鲍曼不动杆菌（9 株）等;G＋球菌10 株（12.5%）,其中耐甲氧西林金黄色葡萄球菌（8 株）;真菌检测出9 株（11.18%）,全部为假丝酵母菌属,其中主要包括光滑念珠菌和白色念珠菌.对比耐药性检测结果显示,绝大部分病原菌具有多重耐药性,并且耐药性有上升的趋势,特别是G- 耐药性较为严重.存活组与死亡组对比,机械通气前抗菌药物应用时间较短,并且培养病原菌数也明显较低.结论：相关性肺炎病原菌以G-菌为主,呈现多重耐药性!机械通气前抗菌药物应用时间及病原菌混合感染严重程度等明显影响患者预后.objective to study the intensive medicine characteristics of ventilator associated pneumonia （VAP） pathogens and their drug resistance. Methods： retrospectiveanalysis of our hospital during March 2011 to March 2011 ICU training accepts the 40 cases of respiratory secretions of infected patients and drug sensitive test results, comparing theclinical data of survival correlation between pneumonia and death group structure characteristics and pathogen. Results： 40 cases of pneumonia in patients with 81 strains pathogenicbacteria detection is given priority to with G - bacteria （75.6%）, which mainly by pseudomonas aeruginosa （34 strains）, acinetobacter baumannii （9 strains）, etc.; G ＋ cocci 10 strains（12.5%）, including methicillin-resistant staphylococcus aureus （8 strains）; Fungi detected 9 strains （11.18%）, all for candida, which mainly include smooth candida and candida albicans.For resistance test results showed that the vast majority of pathogenic bacteria with multiple drug resistance, and resistance has a tendency to rise, especially the G - resistance is moreserious. Survival group and death group contrast, mechanical ventilation and antimicrobial application practice is shorter, and culture have significantly lower, Numbers of pathogens.Conclusion： the correlation between pneumonia pathogen is given priority to with G - bacteria, presents the multiple drug resistance. Mechanical ventilation and antimicrobialapplication time and pathogenic bacteria mixed infection severity significantly affect the prognosis of patients.

关 键 词：重症医学科 呼吸机 肺炎 耐药性 

分 类 号：R563.1[医药卫生—呼吸系统]