论文部分内容阅读
目的:了解儿童呼吸机相关性肺炎的主要病原菌,为临床治疗和预防提供参考。方法:调查我院儿科重症监护病房2000年1月～2005年12月收治的35例呼吸机相关性肺炎患者的临床资料、致病菌及其药敏结果。结果:35例呼吸机相关性肺炎患者分离出病原菌53株,以G~-杆菌为主,占71.69%,依次为铜绿假单胞菌、不动杆菌、肺炎克雷白杆菌;G~+球菌主要为金黄色葡萄球菌及MRSA;分离菌株对大多数抗生素呈高耐药水平。G~-杆菌仅仅对亚胺培南、阿米卡星、妥布霉素、环丙沙星、头孢他啶相对较敏感;未发现G~+球菌包括MRSA耐万古霉素菌株,其余相对敏感的抗生素依次为利福平、环丙沙星、氯霉素;行MV时间>7d是发生呼吸机相关性肺炎的高危因素,头孢类第三代抗生素与多种抗生素联合用药>7 d时易并发真菌感染。结论:依据呼吸机相关性肺炎的高危因素和致病菌及其耐药特性,临床采取相应的预防和治疗措施。
Objective: To understand the main pathogens of ventilator-associated pneumonia in children and provide reference for clinical treatment and prevention. Methods: The clinical data, pathogenic bacteria and drug susceptibility of 35 patients with ventilator-associated pneumonia admitted from January 2000 to December 2005 in our hospital pediatric intensive care unit were investigated. Results: Of the 35 patients with ventilator-associated pneumonia, 53 strains of pathogens were isolated, accounting for 71.69% of the total, accounting for 71.69% of the total, with Pseudomonas aeruginosa, Acinetobacter, Klebsiella pneumoniae; Mainly Staphylococcus aureus and MRSA; isolates were highly resistant to most antibiotics. G ~ - bacilli were only relatively sensitive to imipenem, amikacin, tobramycin, ciprofloxacin and ceftazidime; no G ~ + coccus including MRSA vancomycin resistant strains were found, while the rest of the relatively sensitive antibiotics Followed by rifampicin, ciprofloxacin, chloramphenicol; line MV time> 7d is the risk factors for ventilator-associated pneumonia, the third generation of cephalosporins combined with a variety of antibiotics> 7 d easily complicated by fungi infection. Conclusion: According to the risk factors of ventilator-associated pneumonia and pathogenic bacteria and their drug-resistant characteristics, appropriate preventive and curative measures should be taken clinically.