呼吸机相关性肺炎的痰培养细菌分布和细菌耐药性分析  

Analysis of Bacterial Distribution and Bacterial Resistance in Sputum Culture of Ventilator-associated Pneumonia

作　　者：蒋文玥 沈佳丽[1] 蒋逸 JIANG Wen-yue;SHEN Jia-li;JIANG Yi(Department of Laboratory Medicine,Changzhou Wujin People's Hospital,Changzhou,Jiangsu Province,213000 China)

机构地区：[1]常州市武进人民医院检验科,江苏常州213000

出　　处：《系统医学》2020年第19期37-39,共3页Systems Medicine

摘　　要：目的分析呼吸机相关性肺炎的痰培养细菌分布情况以及细菌耐药性情况。方法以该院2019年1—12月收治的100例呼吸机相关性肺炎(VAP)患者为对象,分别在入院1 d内、机械通气48 h后留取痰液标该实施痰培养,并进行细菌药敏试验,对比不同时间点痰培养细菌分布情况,并总结细菌耐药情况。结果该组100例患者在未发生VAP时致病菌检出率为70.00%,患者在发生VAP后致病菌检出率为92.00%,差异有统计学意义(χ2=15.725,P<0.05);肺炎克雷伯菌对哌拉西林/他唑巴坦、亚胺培南、美罗培南有良好敏感性,没有发现耐药菌株,且对环丙沙星敏感性良好。鲍曼不动杆菌对头孢哌酮/舒巴坦有良好敏感性,对亚胺培南、美罗培南的耐药率较低。铜绿假单胞菌对氨苄西林、头孢唑林的耐药性达到100%,对哌拉西林/他唑巴坦的耐药率较低。结论接受机械通气的患者发生VAP后会影响痰培养分离菌,同时会影响耐药性,提示临床应该做到抗菌药物的合理选择。Objective To analyze the distribution of bacteria in sputum culture of ventilator-associated pneumonia and their drug resistance.Methods 100 patients with ventilator-associated pneumonia(VAP)admitted to the hospital from January to December 2019 were taken as subjects.Sputum samples were collected within 1 d of admission and 48 h after mechanical ventilation for sputum culture and bacterial drug sensitivity experiment,to compare the distribution of bacteria in sputum culture at different time points and summarize the status of bacterial resistance.Results The detection rate of pathogenic bacteria in this group of 100 patients without VAP was 70.00%,and the rate of pathogenic bacteria detection in patients after VAP was 92.00%,the difference was statistically significant(χ2=15.725,P<0.05);Klebsiella pneumoniae bacteria had good sensitivity to piperacillin/tazobactam,imipenem,and meropenem,and no drug-resistant strains are found,and they had good sensitivity to ciprofloxacin.Acinetobacter baumannii had good sensitivity to cefoperazone/sulbactam,but had low resistance rates to imipenem and meropenem.The resistance of Pseudomonas aeruginosa to ampicillin and cefazolin reached 100%,and the resistance rate to piperacillin/tazobactam was low.Conclusion VAP in patients undergoing mechanical ventilation will affect the sputum culture isolates and at the same time affect drug resistance,suggesting that the clinic should make a reasonable choice of antimicrobial drugs.

关 键 词：呼吸机相关性肺炎 痰培养 细菌分布 细菌耐药性 

分 类 号：R563[医药卫生—呼吸系统]