颅脑外伤后呼吸机相关肺炎病原及耐药性分析  

Study of drug resistance and pathogen in head trauma patients with ventilator-associated pneumonia

作　　者：许洁[1] 马延斌[1] 王功大[1] 

机构地区：[1]上海第二医科大学附属宝钢医院,上海201900

出　　处：《现代医药卫生》2003年第11期1378-1379,共2页Journal of Modern Medicine & Health

摘　　要：目的 :分析我院神经外科监护室 (NICU)呼吸机相关肺炎 (VAP)致病菌分布及其耐药情况 ,为临床抗感染治疗提供实验室依据。方法 :对我院NICU1999年1月～2002年12月69例次VAP的病原菌及耐药性进行回顾分析。结果 :共培养65株细菌 ,其中G—杆菌47株 ,占72 3% ,以铜绿假单胞菌为主 (40 4 % ) ;G +菌18株 ,占27 7 % ,其中金黄色葡萄球菌占77 8 % ,耐甲氧西林金葡菌 (MRSA)占金葡萄中的78 6 %。革兰阴性菌对亚胺培南和头孢吡肟耐药率最低 ,MRSA对万古霉素敏感 ,无1例耐药。结论 :NICU中VAP致病菌以G- 菌为主 ,G+菌亦有增加 ,且多为MRSA。NICU中VAP致病菌耐药普遍 。Objective:To study the bacterial distribution and drug resista nce of ventilator-associated pneumonia in NICUand to determine the treament strategies.Methods:Retrospective analysis was performed on bacterial culture,antibiotics sensivity results in69patients with ventiˉlator-associated pneumonia in NICU.Results:In65strains:gram-positive in47strains(72.3%)and gram-negative in18strains(27.7%).The causative pathogens of VAP were pseudomonas aeruginosa(19strains)and staphylococcus aureus(14strains).Methicillin resistant strains accounted for78.6%of S.gram-negative bacteria were susceptible to imipenem and cefepime.No MRSA was resistant to vanˉcomycin.Conclusion:VAP is caused predominantly by gram-negative bacteria.but gram-positive bacteria also markedly.Bacteriological invesˉtigate plays an important role to select rational antibiotics to early treament of VAP.

关 键 词：颅脑外伤 呼吸机 肺炎 病原菌 耐药性 病原学 

分 类 号：R651.15[医药卫生—外科学] R563.1[医药卫生—临床医学]