中外医学研究
中外醫學研究
중외의학연구
CHINESE AND FOREIGN MEDICAL RESEARCH
2014年
32期
49-50,51
,共3页
新生儿%呼吸机相关性肺炎%病原菌分析
新生兒%呼吸機相關性肺炎%病原菌分析
신생인%호흡궤상관성폐염%병원균분석
Newborn%Ventilator-associated pneumonia%Pathogen analysis
目的：探讨新生儿呼吸机相关性肺炎(VAP)的病原菌分析，为临床诊断治疗提供参考。方法：选取笔者所在医院2011年7月-2014年3月收治的57例使用呼吸机机械通气时间≥48 h的VAP患儿，提取下呼吸道分泌物送检，作致病微生物培养及药物敏感试验，对标本进行病原菌分布及抗生素敏感率分析。结果：检出病原菌61株，其中革兰阴性菌占88.52%，革兰阳性菌占4.92%，两种菌检出率比较差异有统计学意义(P<0.05)，其他真菌占6.56%；最主要的病原菌均为革兰阴性菌：肺炎克雷伯菌(24.59%)、大肠埃希菌(19.67%)、阴沟肠杆菌(14.75%)、鲍氏不动杆菌(13.11%)；四种主要革兰阴性菌(肺炎克雷伯菌、大肠埃希菌、阴沟肠杆菌、鲍氏不动杆菌)对阿米卡星、环丙沙星、亚胺培南敏感率为79.55%、77.27%、86.36%，具有高度敏感性，对头孢类抗生素敏感性较低。结论：新生儿呼吸机相关性肺炎病原菌以革兰阴性菌为主，临床治疗新生儿VAP应根据各自地区的病原菌分布及耐药性特点，合理有效地使用抗生素治疗。
目的：探討新生兒呼吸機相關性肺炎(VAP)的病原菌分析，為臨床診斷治療提供參攷。方法：選取筆者所在醫院2011年7月-2014年3月收治的57例使用呼吸機機械通氣時間≥48 h的VAP患兒，提取下呼吸道分泌物送檢，作緻病微生物培養及藥物敏感試驗，對標本進行病原菌分佈及抗生素敏感率分析。結果：檢齣病原菌61株，其中革蘭陰性菌佔88.52%，革蘭暘性菌佔4.92%，兩種菌檢齣率比較差異有統計學意義(P<0.05)，其他真菌佔6.56%；最主要的病原菌均為革蘭陰性菌：肺炎剋雷伯菌(24.59%)、大腸埃希菌(19.67%)、陰溝腸桿菌(14.75%)、鮑氏不動桿菌(13.11%)；四種主要革蘭陰性菌(肺炎剋雷伯菌、大腸埃希菌、陰溝腸桿菌、鮑氏不動桿菌)對阿米卡星、環丙沙星、亞胺培南敏感率為79.55%、77.27%、86.36%，具有高度敏感性，對頭孢類抗生素敏感性較低。結論：新生兒呼吸機相關性肺炎病原菌以革蘭陰性菌為主，臨床治療新生兒VAP應根據各自地區的病原菌分佈及耐藥性特點，閤理有效地使用抗生素治療。
목적：탐토신생인호흡궤상관성폐염(VAP)적병원균분석，위림상진단치료제공삼고。방법：선취필자소재의원2011년7월-2014년3월수치적57례사용호흡궤궤계통기시간≥48 h적VAP환인，제취하호흡도분비물송검，작치병미생물배양급약물민감시험，대표본진행병원균분포급항생소민감솔분석。결과：검출병원균61주，기중혁란음성균점88.52%，혁란양성균점4.92%，량충균검출솔비교차이유통계학의의(P<0.05)，기타진균점6.56%；최주요적병원균균위혁란음성균：폐염극뢰백균(24.59%)、대장애희균(19.67%)、음구장간균(14.75%)、포씨불동간균(13.11%)；사충주요혁란음성균(폐염극뢰백균、대장애희균、음구장간균、포씨불동간균)대아미잡성、배병사성、아알배남민감솔위79.55%、77.27%、86.36%，구유고도민감성，대두포류항생소민감성교저。결론：신생인호흡궤상관성폐염병원균이혁란음성균위주，림상치료신생인VAP응근거각자지구적병원균분포급내약성특점，합리유효지사용항생소치료。
Objective:To investigate the analysis of pathogenic bacteria of neonatal ventilator-associated pneumonia,and provide reference for clinical diagnosis and treatment.Method:57 children with VAP using mechanical ventilation time≥48h admitted to our hospital from July 2011 to March 2014 were selected,lower respiratory tract secretions were extracted,made pathogenic microorganism culture and drug sensitive test,analyzed the distribution of pathogens and antibiotic sensitive rate of specimens.Result:61 pathogenic bacteria were detected,including gram negative bacteria accounted for 88.52%,gram positive bacteria accounted for 4.92%,the difference was statistically significant in the detection rate between two kinds of bacteria(P<0.05),other fungi accounted for 6.56%.The predominant pathogenic bacteria were gram negative bacterium:Klebsiella pneumoniae (24.59%),Escherichia coli (19.67%),Enterobacter cloacae (14.75%),Acinetobacter baumannii coli (13.11%).Four main gram negative bacterium (Klebsiella pneumoniae,Escherichia coli,Enterobacter cloacae, Acinetobacter baumannii) to Amikacin,ciprofloxacin and imipenem sensitive rate were 79.55%,77.27%,86.36%,had high sensitivity,lower susceptibility to cephalosporins.Conclusion:The neonatal ventilator associated pneumonia pathogen mainly gram-negative bacteria,clinical treatment of neonatal VAP should be based on the distribution of pathogens and their antibiotic resistance characteristics of each region,using antibiotics reasonably and effectively.
