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目的研究医院重症监护室(ICU)呼吸机相关性肺炎(VAP)病原菌的分布及其耐药性,为制定有效控制VAP的措施提供依据。方法通过回顾性分析方法,对某医院ICU住院VAP患者病原学标本检验结果进行统计分析。结果该医院ICU连续3年从VAP患者送检标本中共分离出病原菌367株,其中革兰阴性菌占69.75%;革兰阳性球菌和真菌分别占22.07%和8.18%。分离菌株居前5位依次是鲍曼不动杆菌、肺炎克雷伯菌、铜绿假单胞菌、金黄色葡萄球菌和大肠埃希菌。VAP患者标本分离的鲍曼不动杆菌和铜绿假单胞菌对多数抗菌药物的耐药率均超过50%。结论该ICU患者VAP病原菌以革兰阴性菌为主,其耐药率较高,应合理使用抗菌药物,降低病原菌的耐药率。
Objective To study the distribution and drug resistance of pathogenic bacteria in ventilator-associated pneumonia (VAP) in hospital intensive care unit (ICU) and provide the basis for the development of effective measures to control VAP. Methods The retrospective analysis method was used to analyze the results of etiological test of VAP patients hospitalized in a hospital ICU. Results The ICU of the hospital collected 367 pathogens from VAP patients for three consecutive years, of which Gram-negative bacteria accounted for 69.75% and Gram-positive cocci and fungi accounted for 22.07% and 8.18% respectively. The top 5 isolates were Acinetobacter baumannii, Klebsiella pneumoniae, Pseudomonas aeruginosa, Staphylococcus aureus and Escherichia coli. Acinetobacter baumannii and Pseudomonas aeruginosa isolated from VAP patients showed more than 50% resistance to most antibiotics. Conclusion The pathogens of VAP in this ICU are Gram-negative bacteria, and their drug resistance rate is high. Antibiotics should be used rationally to reduce the drug resistance rate of pathogens.