某医院呼吸机相关肺炎患者标本中多重耐药菌分离结果分析  

Study on hospital infections of multidrug- resistant organisms for ventilator-associated pneumonia patients

作　　者：贾磊[1] 陆锦琪[1] 马燮峰[1] 刘宇婷[1] 蔡莹[1] 张玉琦[1] 

机构地区：[1]浙江省嘉兴市第一医院,浙江嘉兴314000

出　　处：《中国消毒学杂志》2016年第6期544-546,共3页Chinese Journal of Disinfection

摘　　要：目的了解医院住院患者呼吸机相关肺炎(VAP)标本多重耐药菌(MDROs)分离结果及其感染相关因素。方法通过回顾性调查方法,对某医院重症医学科(ICU)实施气管插管或气管切开使用呼吸机的患者病原学标本检测结果进行统计分析。结果共调查接受机械通气患者997例,发生VAP患者120例,VAP的发病率为12.04%,千日感染率为11.14‰。从120例VAP患者送检标本中检出病原菌120株,含MDROs78株,构成比为65.00%。MDROs中以鲍曼不动杆菌、铜绿假单胞菌和金黄色葡萄球菌分居前3位。经分析发现,住院时间、呼吸机使用时间、长期使用抗菌药物以及GCS评分等因素对患者感染MDROs具有一定的相关性。结论该医院ICU患者VAP病原菌中有65%为MDROs菌株,长时间使用抗菌药物和使用呼吸机是导致患者感染MDROs的重要因素。Objective To understand the situation of multiple drug resistant bacteria（MDROs） isolated from patients with Ventilator Associated Pneumonia（VAP） in hospital and the factors related to this infection.Methods Retrospective survey method and statistical analysis were used to understand the detection results of the pathogens in the patients for the implementation of endotracheal intubation or tracheotomy in Intensive Care Unit of this hospital.Results A total of 997 patients received mechanical ventilation and 120 patients with VAP were found with the incidence rate of VAP of 12.04% and the infection rate was 11.14%.120 strains of pathogens were isolated from120 VAP patients,which including 78 strains of MDROs that accounting for 65%.In MDROs isolated strains of Acinetobacter baumannii,Pseudomonas aeruginosa and Staphylococcus aureus were the top 3.Analysis found that the length of stay,ventilator time,long- term use of antibiotics and other factors on the GCS score of patients infected with MDROs had a certain relevance.Conclusion 65% of pathogens isolated from VAP patients in ICU of the hospital are MDROs strains.Long time use of antibiotics and the ventilator are the essential factors of the patients with MDROs infection.

关 键 词：多重耐药菌 呼吸机相关肺炎 危险因素 

分 类 号：R378[医药卫生—病原生物学]