ICU呼吸机相关性肺炎病原菌分布和耐药性分析.pdf

ICU呼吸机相关性肺炎病原菌分布和耐药性分析 刘璐;魏欣;许家宣;祝海滨 【摘要】目的 了解我院 ICU 呼吸机相关性肺炎(ventilator-associated pneumonia,VAP)的病原菌分布和耐药性状况,为临床合理应用抗菌药物提供病原 学依据.方法 回顾性分析 2014 年 1 月—2016 年 12 月我院 ICU 诊断为 VA 的 118 例患者的基本资料,并分析气管深部分泌物的病原菌的构成比和药敏试验结果 . 结果从 118 例 VA 确诊患者气管深部分泌物中共检出 130 株病原菌.其中革兰阴 性菌 103 株(79.23％),革兰阳性菌 20 株(15.38％),真菌 7 株(5.38％).革兰阴性菌主 要包括:鲍曼溶血不动杆菌 33 株(32.04％),粘质沙雷菌 20 株(19.42％)、肺炎克雷 伯杆菌 18 株(17.47％),铜绿假单胞菌 11 株(10.68％),大肠埃希菌 10 株(9.71％);革 兰阳性菌主要为金黄色葡萄球菌 10 株(50.00％).其中粘质沙雷菌、肺炎克雷伯菌、 铜绿假单胞菌和大肠埃希菌对亚胺培南和阿米卡星的耐药率均低于 10.00％,而鲍 曼溶血不动杆菌对多种常见抗生素的耐药率均超过 80.00％(美罗培南 81.97％、 阿米卡星 83.61％、头孢曲松 88.33％、左氧氟沙星 80.33％).金黄色葡萄球菌对 万古霉素、利奈唑胺和替考拉宁均敏感.结论 我院 ICU 中 VA 患者感染主要以革 兰阴性菌为主,且存在多重耐药现象.了解 VA 的病原菌分布和耐药性,对于合理应 用抗生素、提高治愈率等方面有极大帮助.%Objective To analyze the distribution and drug resistance of pathogenic bacteria of ventilator- associated pneumonia(VAP) in ICU of our hospital to provide the retional drugs for the clinical application. Methods A retrospective analysis of the basicdata of 118 VAP patients from January 2014 to December 2016 in ICU of Huainan First Peoples Hospital, and the pathogens and drugresistance constituent ratio of the deep tracheal secretions of analysis the pathogenic bacteria and drug sensitivity Results had been done. Results One hundred and thirty strains pathogenic bacteria were detected from the deep tracheal secretions of 118 patients with VAP,of which there were 103 strains Gram negative bacteria (79.23％), 20 strains Gram positive bacteri (15.38％) and 7 strains fungi (5.38 ％).Gram negative bacteria included: 33 strains Bauman Acinetobacter haemolyticus (32.04％), 20 strains Serrati marcescens (19.42％), 18strains Klebsiella pneumoniae (17.47 ％), 11 strains Pseudomonas aeruginosa (10.68％), 10 strains Escherichia coli (9.71 ％). Gram positivebacteria were 10 strains Staphylococcus aureus (50.00 ％). And Serratia marcescens, Klebsiella pneumoniae, Pseudom