重症监护病房重症患者呼吸机相关肺炎的病原菌特点及来源的研究  

Study on the characteristics and sources of pathogenic bacteria of ventilator-associated pneumonia in critically ill patients of ICU

作　　者：陈洪英[1] 李爱琴[1] 王晓琼[1] 张娓[1] 崔可[1] CHEN Hong-ying;LI Ai-qin;WANG Xiao-qiong;ZHANG Wei;CUI Ke(Taizhou Hospital of Zhejiang Province,Taizhou Zhejiang 317000,China)

机构地区：[1]浙江省台州医院,浙江台州317000

出　　处：《中国消毒学杂志》2020年第10期730-732,共3页Chinese Journal of Disinfection

摘　　要：目的研究医院重症监护病房(ICU)住院重症患者呼吸机相关肺炎(VAP)病原菌特点及其来源。方法通过病原学标本分离鉴定技术,对某医院ICU住院使用呼吸机的重症患者送检标本进行分离鉴定。结果在确诊的238例VAP患者中,早发型VAP患者98例,迟发性VAP患者140例。从98例早发型患者送检标本中,共分离出病原菌120株,依次为革兰阴性菌83株、革兰阳性菌35株和真菌2株;病原菌主要分离自胃液和口咽部分泌物。从140例迟发型患者送检标本中,共分离出病原菌168株,依次为革兰阴性菌108株、革兰阳性菌42株和真菌18株;病原菌主要分离自气管导管套囊和胃液。两组患者的病原菌分布情况进行比较,差异具有统计学意义(P<0.05)。结论医院ICU住院VAP患者感染病原菌分布存在差异,应依据调查结果制定有效防控措施。Objective To study the characteristics and sources of pathogenic bacteria of ventilator-associated pneumonia(VAP)in critically ill patients at intensive care unit(ICU)of a hospital.Methods The pathogenic specimens of critically ill patients who were hospitalized on a ventilator in ICU were isolated and identified by corresponding method,Results Among the 238 confirmed VAP patients,98 were early-onset VAP patients and 140 were late-onset VAP patients.From the specimens submitted by 98 early-onset patients,a total of 120 pathogens were isolated,including 83 strains of Gram-negative bacteria,35 strains of Gram-positive bacteria and 2 strains of fungi;the pathogens were mainly isolated from gastric juice and oropharyngeal secretions.A total of 168 pathogens were isolated from the specimens of 140 delayed-onset patients,including 108 strains of Gram-negative bacteria,42 strains of Gram-positive bacteria and 18 strains of fungi;the pathogens were mainly isolated from tracheal tube cuffs and gastric juice.The distribution of pathogens between the two groups was compared,and the difference was statistically significant(P<0.05).Conclusion There are differences in the distribution of pathogens in VAP patients hospitalized in ICU,and effective prevention and control measures should be formulated based on the survey results.

关 键 词：重症监护病房 呼吸机相关肺炎 病原菌 来源 

分 类 号：R378[医药卫生—病原生物学]