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目的分析急诊科患者呼吸机相关肺炎的病原学分布情况及药物敏感性,为指导临床合理使用抗生素提供依据。方法对急诊科确诊为呼吸机相关性肺炎的患者104例进行病原学的分析及药敏试验结果的分析。结果 104例患者中,共检出致病菌247例,其中革兰氏阳性菌36例(14.57%),革兰氏阴性菌184例(74.49%),真菌11例(10.93%)。在革兰氏阴性菌中,主要的病原菌分布为,铜绿假单胞菌79例(31.98%),鲍曼不动杆菌58例(23.48%),大肠埃希菌31例(12.55%),肺炎克雷伯菌19例(7.69%)。革兰氏阴性致病菌主要对碳青霉烯类及β内酰胺酶抑制剂联合用药较为敏感(敏感度>80%),其余抗生素的耐药情况均较为严重(敏感性<80%)。结论急诊科呼吸机相关肺炎患者病因均耐药的情况较为普遍,联合用药及合理使用抗生素是提高患者治疗效果的重要手段。
Objective To analyze the etiological distribution and drug sensitivity of ventilator-associated pneumonia in emergency department and provide the basis for clinical rational use of antibiotics. Methods 104 cases of patients diagnosed as ventilator-associated pneumonia in emergency department were analyzed by etiology and the results of drug susceptibility test were analyzed. Results A total of 247 pathogens were detected in 104 patients, including 36 Gram-positive bacteria (14.57%), 184 Gram-negative bacteria (74.49%) and 11 fungi (10.93%). In Gram-negative bacteria, the distribution of the main pathogenic bacteria was 79 cases (31.98%) of Pseudomonas aeruginosa, 58 cases (23.48%) of Acinetobacter baumannii, 31 cases (12.55%) of Escherichia coli, pneumonia Klebsiella in 19 cases (7.69%). Gram-negative pathogens are mainly sensitive to carbapenems and β-lactamase inhibitors combined (sensitivity> 80%), and the remaining antibiotics are more resistant (sensitivity <80%). Conclusion The etiology of emergency department patients with ventilator-associated pneumonia is more common. Combined treatment and rational use of antibiotics are important ways to improve the therapeutic effect of patients.