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目的探讨我院呼吸机相关性肺炎(VAP)患者的致病菌分布特点和耐药特性。方法回顾调查分析2012年1月至2014年12月我院综合ICU呼吸机相关性肺炎患者痰培养及药敏试验结果。结果203例VAP患者痰培养共检出339株致病菌,革兰氏阴性杆菌占据大部分(67.85%),其总体耐药性较高,其中以鲍曼不动杆菌居首位(20.06%),铜绿假单胞菌(16.52%)次之,肺炎克雷伯菌(10.61%)、大肠埃希菌(8.85%)分别位列第三、四位;耐甲氧西林金黄色葡萄球菌(MRSA)占据革兰氏阳性菌的主要部分(14.45%)。结论革兰氏阴性杆菌占据我院综合ICU VAP病原菌主要部分,多重耐药性严重,动态监测患者病原菌分布特点和耐药特性有利于VAP的治疗。
Objective To investigate the distribution and drug resistance of pathogens in patients with ventilator-associated pneumonia (VAP) in our hospital. Methods Retrospective investigation and analysis of sputum culture and drug susceptibility test results of patients with ICU ventilator-associated pneumonia in our hospital from January 2012 to December 2014 were retrospectively analyzed. Results A total of 339 pathogenic bacteria were detected in sputum culture of 203 patients with VAP. Gram-negative bacilli accounted for the majority (67.85%) of the patients with VAP. The overall drug resistance was high, among which Acinetobacter baumannii was the highest (20.06% ), Pseudomonas aeruginosa (16.52%) followed by Klebsiella pneumoniae (10.61%), Escherichia coli (8.85%) were ranked third and fourth; methicillin-resistant Staphylococcus aureus MRSA) occupies the major part of Gram-positive bacteria (14.45%). Conclusions Gram-negative bacilli occupy the main part of the comprehensive ICU VAP pathogens in our hospital, and the multi-drug resistance is serious. The dynamic distribution of pathogenic bacteria and drug resistance characteristics of patients are favorable for the treatment of VAP.