佛山地区呼吸机相关性肺炎病原学及细菌耐药性变迁探究.docVIP

佛山地区呼吸机相关性肺炎病原学及细菌耐药性变迁探究[摘要] 目的：探讨佛山地区呼吸机相关性肺炎（VAP）病原学与细菌耐药性变迁状况。方法：将我市3家医院的120例VAP进行痰细菌培养及药敏试验，总结分析病原学与细菌耐药性变迁。结果：铜绿假单胞菌检出率在两年度均占首位，分别为21.33%及26.15%，并对头孢噻肟100%耐药，对亚胺培南也产生了严重耐药，耐药率由原来的0增至47.06%，对头孢哌酮/舒巴坦和头孢他啶的耐药率分别由原来的12.50%和25.00%增至52.49%和41.17%，对阿米卡星、左旋氧氟沙星和哌拉西林/他唑巴坦等药物的耐药率也不同程的增加；鲍曼不动杆菌和嗜麦芽假单胞菌两年度检出率分别为17.33%、16.92%和8.00%、12.34%，在两年内对多种抗生素的耐药性均有不同程度的增加；肺炎克雷伯菌和洋葱假单胞菌的检出率两年来出现下降趋势，真菌在两年度中仍具有较高的检出率，未发现耐药菌株。结论：各个细菌对抗生素的耐药谱不断发生变化，临床医师应及时掌握病原学及耐药性的变迁，并合理选择抗生素。 [关键词] 呼吸机相关性肺炎；病原学；细菌耐药性 [中图分类号] R563.1[文献标识码] C [文章编号]1673-7210（2011）08（a）-126-03 Study on etiology and bacterial drug resistance transition of ventilator associated pneumonia in Foshan area MEI Zhanqiang1, LIN Jinsong2, XU Xiaopeng3 1.Department of Respiratory Medicine, The First Hospital of Foshan City, Guangdong Province, Foshan 528000, China; 2.Department of Respiratory Medicine, the People’s Hospital of Shunde District of Foshan City, Guangdong Province, Foshan 528300, China; 3. Department of ICU, the People’s Hospital of Gaoming District of Foshan City, Guangdong Province, Foshan 528500 [Abstract] Objective: To investigate the etiology and bacterial drug resistance transition of ventilator associated pneumonia in Foshan area. Methods: The phlegm with germiculture and the drug sensitive was tested in 120 cases with VAP in 3 hospitals, and the etiology and bacterial drug resistance transition were summerized. Results: The detection rate of pseudomonas aeruginosa in two years were 21.33% and 26.15%, and the resistance rate on Cefoperazone and Ceftazidime were raised from 12.50% and 25.00% to 52.49% and 41.17%. And the resistance rate on Amikacin, Levofloxacin and Piperacillin raised in some extent. The detection rate of acinetobacter baumannii and pseudomonas maltophilia in two years were 17.33% and 16.92%, 8.00% and 12.34% respectively, and the resistance rate on many antibiotic raised in some extent. The detection rate of klebsiella pneumonia and pseudomonas cepacia were decreased in two