某医院呼吸科重症监护病房呼吸机相关性肺炎病原菌分布和影响因素分析  

Pathogen bacteria distribution and influencing factors analysis of ventilator associated pneumonia in RICU of a hospital

作　　者：刘卫平 董博伟 张凯 邢慧敏 赵宇平 张帅 杨永芳 杨丽芳 刘丽 LIU Wei-ping;DONG Bo-wei;ZHANG Kai;XING Hui-min;ZHAO Yu-ping;ZHANG Shuai;YANG Yong-fang;YANG Li-fang;LIU Li(Inner Mongolia people's hospital,Hohhot Inner Mongolia 010010,China)

机构地区：[1]内蒙古自治区人民医院,内蒙古呼和浩特010010

出　　处：《中国消毒学杂志》2022年第6期438-441,共4页Chinese Journal of Disinfection

基　　金：内蒙古自治区卫生健康科技计划(202101024);内蒙古自治区人民医院院内基金(2021YN03)。

摘　　要：目的了解医院呼吸科重症监护病房(RICU)患者呼吸机相关性肺炎(VAP)病原菌分布特点及主要影响因素。方法采用回顾性调查方法对某医院2018年1月—2020年12月收治的257例RICU患者的病原菌分布、VAP发生情况及其相关影响因素进行分析。结果257例RICU患者中,有64例患者发生VAP,发生率为24.90%。64例患者的痰标本中,共检出114株病原菌,其中84株为革兰阴性菌,占73.68%;19株革兰阳性菌,占16.67%;11株真菌,占9.65%。多因素Logistic回归分析结果显示,年龄、机械通气时间长、气管插管或切开、入住RICU时间长、预防抗菌药物使用及合并糖尿病是RICU患者VAP发生的独立相关因素。结论引发RICU患者VAP的病原菌以革兰阴性菌居多,其发生风险与治疗因素、合并基础疾病有关。Objective To know pathogen bacteria distribution and influencing factors of ventilator associated pneumonia(VAP)in respiratory intensive care unit(RICU).Methods Retrospective investigation was used to analysis pathogen bacteria distribution and influencing factors of 257 patients in RICU during January,2018 to December,2020 in a hospital.Results 64 patients of 257 RICU patients infected VAP and the infection rate was 24.90%.From phlegm sample of 64 patients,114 strains of pathogen bacteria were detected.Among them 84 strains were Gram negative which accounted for 73.68%;19 strains were Gram positive which accounted for 16.67%;11 strains were fungus which accounted for 9.65%.According to result of multi-factor logistic regression,age,long time of ventilator use,ventilator use or tracheotomy,long time of RICU stay,preventive antibiotics combined use,and diabetes were independent influencing factors of VAP occurred in RICU.Conclusion Pathogen bacteria causing VAP occurred in RICU are mainly Gram negative bacteria.The risk is associated with therapy factors and basis desease.

关 键 词：呼吸科重症监护病房 呼吸机相关性肺炎 病原菌 影响因素 

分 类 号：R181.3+2[医药卫生—流行病学] R187[医药卫生—公共卫生与预防医学]