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目的 :了解呼吸机相关性肺炎 (VAP)的致病菌分布及耐药情况 ,以指导临床用药及预防。方法 :对 33例病人的 5 2个深部痰标本进行培养及药敏试验。结果 :细菌培养以G- 菌为主 ,4 8例阳性 ,G+ 菌 3例和真菌 1例。G- 菌中以绿脓假单胞、大肠埃希氏、阴沟肠杆菌和肺炎克雷白常见。敏感的抗菌素主要为泰能、哌拉西林 +他唑巴坦、头孢他定 ,喹诺酮和氨基糖甙类也较敏感 ,但对大部分三代头孢菌素均耐药。结论 :呼吸机相关性肺炎的致病菌主要是多重耐药菌 ,依据药敏试验选用恰当抗菌素 ,同时应用选择性肠道脱污染和肠道营养防治肠道细菌移位有一定意义
Objective: To understand the distribution and drug resistance of pathogens in ventilator-associated pneumonia (VAP) to guide clinical use and prevention. Methods: Fifty-two deep sputum specimens of 33 patients were cultured and drug susceptibility test. Results: The main bacteria were G - bacteria, 48 positive, 3 G + and 1 fungus. Pseudomonas aeruginosa, Escherichia coli, Enterobacter cloacae and Klebsiella pneumoniae are common. Sensitive antibiotics are mainly to Thailand, piperacillin + tazobactam, ceftazidime, quinolones and aminoglycosides are also more sensitive, but most third-generation cephalosporins are resistant. Conclusions: The pathogens of ventilator-associated pneumonia are mainly multi-drug-resistant bacteria. According to drug-susceptibility test, appropriate antibiotics are used, and selective intestinal decontamination and enteral nutrition are helpful to prevent intestinal bacterial translocation