首頁 > 期刊首頁 > 中國當代醫藥 > 2009年12期 > ICU內呼吸機相關性肺炎的病原菌及耐藥性分析
ICU內呼吸機相關性肺炎的病原菌及耐藥性分析
Analysis for the pathogens and drug resistance of VAP in ICU
- doi：
- 摘要：
- 目的:分析重癥監護室(ICU)呼吸機相關性肺炎(VAP)的病原菌分布及耐藥情況.方法:分析2007年1月～2008年12月在重癥監護室發生YAP的患者資料,對其病原菌分布及耐藥情況進行匯總.結果:63例VAP患者中共檢出138株致病菌,其中革蘭陰性菌(G-)67.4%,革蘭陽性菌(G+)12.3%,真菌20.3%.大多數G-菌對常用的抗菌藥已表現出較高的耐藥性.金黃色葡萄球菌耐藥性嚴重,對苯唑西林的耐藥率達92.9%,但對萬古霉素、利奈唑烷均敏感.結論:VAP的病原菌以G-桿菌占優勢.并且致病菌呈多重耐藥性.在采取經驗性治療時,應選擇對常見致病菌有較好覆蓋率且耐藥率低的抗生素,并重視病原菌的檢查,指導合理使用抗生素.
- Abstract：
- Objective: To analyze the pathogens and the drug-resistance of ventilator-associated pneumonia (VAP) in ICU. Methods: Among 63 patients with VAP in intensive care unit (ICU) in our hospital between Jan 2007 and Dec 2008, pathogens distribution and drug-resistance rate were analyzed. Results: Totally 138 pathogens were cultivated altogether in all 63 VAP patients. Among the pathogens, the Gram-negative bacteria(GNB)accounted for 67.4%, the Gram-positive bac-teria(GPB) for 12.3%, and the fungi for 20.3%. Most of the GNB showed high resistance rote to common used antibiotics. Staphylococns anrens had severe drug-resistance to oxacillin but it was still highly susceptible to vancomycin and linezoid. Conclusion: GNB is still the major pathogens of VAP. Multi--drug--resistance (MDR) could be occurred in most of the pathogens. Given the possible multiple drug resistance of pathogen, appropriate antibiotics with low drug resistance of potential should be empirically used against infection. Pathogen test prior to or concurrent with anti-microbiological therapy is important in guiding the reasonable application of antibiotics.
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