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目的探讨重症监护室(ICU)呼吸机相关性肺炎(VAP)的病原菌分布及耐药情况。方法对某院(ICU)2007年10月至2010年10月诊断为呼吸机相关性肺炎的118例患者病原学资料进行回顾性分析。结果检出病原菌222株,其中革兰阴性菌142株(63.96%),主要为鲍曼不动杆菌(39株)、铜绿假单胞菌(29株);革兰阳性菌(60株)(27.03%),主要为金黄色葡萄球菌(19株)其中耐甲氧西林13株(68.42%);真菌20株,占9.01%。铜绿假单胞菌耐药率<30%的抗菌药物为亚胺培南、头孢他啶。金黄色葡萄球菌特别是MRSA除对万古毒素敏感外,对青霉素、克林霉素、红霉素耐药率均>80%。结论医院ICU中VAP病原菌以革兰阴性菌为主,普遍细菌耐药。
Objective To investigate the distribution and drug resistance of pathogens in intensive care unit (ICU) ventilator-associated pneumonia (VAP). Methods The etiological data of 118 patients diagnosed as ventilator-associated pneumonia from October 2007 to October 2010 in a hospital (ICU) were analyzed retrospectively. Results 222 strains of pathogens were detected, of which 142 strains (63.96%) were Gram-negative bacteria, mainly Acinetobacter baumannii (39 strains), Pseudomonas aeruginosa (29 strains), Gram-positive bacteria 27.03%), mainly Staphylococcus aureus (19 strains), including 13 methicillin-resistant strains (68.42%) and 20 fungi (9.01%). Pseudomonas aeruginosa drug resistance rate of <30% of the antibacterial drugs imipenem, ceftazidime. Staphylococcus aureus, especially MRSA in addition to the versatic toxin sensitive, penicillin, clindamycin, erythromycin resistance rates were> 80%. Conclusion The pathogens of VAP in hospital ICU are gram-negative bacteria, and common bacteria are drug-resistant.