论文部分内容阅读
目的分析急诊重症监护病房呼吸机相关肺炎(VAP)临床特点及病原学的耐药性,为合理应用抗生素、预防和减少VAP的发生提供指导依据。方法以2008-02～2011-02急诊重症监护室VAP患者为对象,回顾性分析其临床特点、病原菌谱及其耐药性。结果共分离出细菌164株,其中革兰阴性(G-)杆菌112株(68.29%),革兰阳性(G+)球菌52株(31.71%)。铜绿假单胞菌、鲍曼不动杆菌、大肠埃希杆菌、肺炎克雷伯菌、金黄色葡萄球菌及白色念珠菌。合并真菌感染率达32.20%(38/118)。鲍曼不动杆菌对头孢哌酮/舒巴坦耐药率较低,铜绿假单胞菌对亚胺培南耐药率较低。未发现耐万古霉素G+菌。结论急诊重症监护室内VAP病原菌以G-菌为主,混合感染比例高,耐药问题严重。加强机械通气患者综合管理措施,防与治相结合,有助于提高机械通气患者的救治成功率。
Objective To analyze the clinical features and etiological drug resistance of ventilator-associated pneumonia (VAP) in emergency ICU and to provide guidance for rational use of antibiotics and prevention and reduction of VAP. Methods A retrospective analysis of the clinical features, pathogenic bacteria spectrum and drug resistance of VAP patients in Emergency Intensive Care Unit from February 2008 to February 2011 was conducted. Results A total of 164 bacteria were isolated, of which 112 (68.29%) were Gram-negative bacteria and 52 (31.71%) were Gram-positive bacteria. Pseudomonas aeruginosa, Acinetobacter baumannii, Escherichia coli, Klebsiella pneumoniae, Staphylococcus aureus and Candida albicans. The combined fungal infection rate was 32.20% (38/118). Acinetobacter baumannii lower the rate of cefoperazone / sulbactam resistance, low resistance to imipenem Pseudomonas aeruginosa. No vancomycin-resistant G + bacteria were found. Conclusion The main pathogen of VAP in emergency intensive care unit is G-bacteria, with high infection rate and serious drug resistance. Strengthen the comprehensive management of patients with mechanical ventilation, prevention and treatment combined to help improve the success rate of treatment of patients with mechanical ventilation.