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目的 了解普通病房与重症监护室 (ICU)感染患儿病原菌的分布特点 ,并探讨呼吸机相关性肺炎(VAP)的致病因素。方法 对重庆医科大学儿童医院 2 0 0 3年各类送检的培养标本和 2 4例机械通气患儿资料进行总结分析。结果 全院普通内外科病房儿童感染细菌的构成比中革兰阳性球菌所占比例为 4 8 3% ,革兰阴性杆菌占 5 0 2 % ,PICU病房感染菌分布革兰阴性杆菌明显增加 ,占 88 3% ,革兰阳性球菌仅占 8 3% ,VAP感染菌分别以铜绿假单胞菌、鲍曼不动杆菌、真菌占前 3位。结论 革兰阴性杆菌已成为ICU和VAP的优势菌群 ,对临床常用抗生素均有多重耐药现象。
Objective To investigate the distribution of pathogenic bacteria in children with common ward and intensive care unit (ICU) infection and to explore the pathogenesis of ventilator-associated pneumonia (VAP). Methods The data of all kinds of specimens sent for examination and 24 cases of children with mechanical ventilation from Children’s Hospital of Chongqing Medical University in 2003 were analyzed. Results The proportion of gram-positive bacilli among the children in general ward hospital was 48.3% and that of gram-negative bacilli was 52.02%. The gram-negative bacilli in the wards of PICUs were significantly increased 88 3%, Gram-positive cocci accounted for only 83%, VAP-infected bacteria were Pseudomonas aeruginosa, Acinetobacter baumannii, fungi accounted for the first three. Conclusion Gram-negative bacilli have become the dominant micro-flora of ICU and VAP, and have multi-drug resistance to commonly used antibiotics.