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目的了解新生儿重症监护中心(NICU)中早产儿呼吸机相关性肺炎(VAP)病原菌分布、耐药情况及防治措施。方法对2004年1月—2007年12月间在我院NICU住院治疗期间发生VAP的67例早产儿临床资料进行分析。结果 67例患儿中临床治愈44例,死亡11例,放弃治疗12例;67例痰标本中共检出细菌56例,革兰氏阴性杆菌53株(94.64%),革兰氏阳性球菌3株(5.36%)。结论革兰氏阴性杆菌(肺炎克雷伯杆菌、大肠埃希菌、铜绿假单孢菌、鲍曼不动杆菌)为早产儿VAP主要致病菌,对泰能、环丙沙星敏感,随着头孢类广谱抗生素的广泛应用,超广谱β-内酰胺酶(ESBLs)株目益增多。
Objective To investigate the distribution, drug resistance and prevention and cure of ventilator-associated pneumonia (VAP) in preterm infants in neonatal intensive care center (NICU). Methods Clinical data of 67 preterm infants with VAP who were hospitalized during NICU in our hospital from January 2004 to December 2007 were analyzed. Results Of the 67 cases, 44 cases were cured, 11 died, and 12 cases were given up. Among the 67 sputum samples, 56 were bacterial, 53 Gram-negative bacilli (94.64%), 3 Gram-positive cocci (5.36%). Conclusions Gram-negative bacilli (Klebsiella pneumoniae, Escherichia coli, Pseudomonas aeruginosa and Acinetobacter baumannii) are the main pathogens of VAP in preterm infants and are sensitive to tacrine and ciprofloxacin. Extensive use of cephalosporins broad-spectrum antibiotics, extended spectrum of β-lactamase (ESBLs) strains benefit more.