ICU呼吸机相关肺炎病原菌分布及耐药性分析  

Distribution and Drug Resistance Analysis of Pathogenic Bacteria in ICU Ventilator-associated Pneumonia

作　　者：钦晓英 项小燕[2] 黄培[2] 培崔智萍 朱薇 QIN Xiao-ying;XIANG Xiao-yan;HUANG Pei-pei;CUI Zhi-ping;ZHU Wei(Zhejiang Chinese Medical University;Zhejiang Provincial People’s Hospital/People’s Hospital of Hangzhou Medical College)

机构地区：[1]浙江中医药大学 [2]浙江省人民医院/杭州医学院附属人民医院

出　　处：《医院管理论坛》2022年第6期54-57,5,共5页Hospital Management Forum

摘　　要：目的 分析ICU呼吸机相关肺炎感染的病原菌分布、耐药特征。方法 回顾性分析175例呼吸机相关肺炎患者的临床资料并进行统计学分析。结果 240株临床分离株中革兰阴性菌、阳性菌和真菌分别占83.75%、7.08%和9.17%。29.14%患者存在病原菌混合感染,60.78%为2种及2种以上革兰阴性菌混合感染。鲍曼不动杆菌、皮氏罗尔斯顿菌和嗜麦芽窄食单胞菌对碳青霉烯类耐药率超过90%,除肺炎克雷伯菌外,其余主要革兰阴性菌多重耐药率大于85.19%。54.55%的金黄色葡萄球菌耐甲氧西林,63.64%的金黄色葡萄球菌多重耐药。结论 呼吸机相关肺炎患者以感染革兰阴性菌为主,多重耐药现象严重,临床应根据药敏试验结果合理选用抗菌药物。Objective associated pneumonia infection. Methods The clinical data of 175 patients with ventilator-associated pneumonia were retrospectively analyzed and statistically analyzed. Results Gram-negative bacteria, positive bacteria and fungi accounted for 83.75%, 7.08% and 9.17% of the 240 clinical isolates, respectively. 29.14% of patients had mixed infection of pathogenic bacteria, and 60.78% had mixed infection of two or more gram-negative bacteria. The drug resistance rates of Acinetobacter baumannii, Ralstonia pischei and Stenotrophomonas maltophilia to carbapenems were more than 90%. Except for Klebsiella pneumoniae, the multiple drug resistance rates of other major gram-negative bacteria were greater than 85.19%. 54.55% of Staphylococcus aureus were methicillin-resistant, and 63.64% of Staphylococcus aureus were multi-drug resistant. Conclusion Patients with ventilator-associated pneumonia are mainly infected with Gram-negative bacteria, and the phenomenon of multi-drug resistance is serious. Antibacterial drugs should be rationally selected according to the results of drug susceptibility test.

关 键 词：重症监护病房 呼吸机相关肺炎 病原菌 耐药性 

分 类 号：R197.3[医药卫生—卫生事业管理]