CAJ | 학술논문

目的分析我院呼吸机相关性肺炎(VAP)的病原学特点及耐药情况.方法对我院综合重症监护室和呼吸重症监护室2011年1月至2012年8月诊断为VAP的44例患者病原学资料进行回顾性分析.结果 44例患者支气管分泌物培养获得致病菌83株,其中革兰阴性杆菌63株,占75.9％；革兰阳性球菌14株,占16.9％；真菌6株,占7.2％.革兰阴性杆菌中占前6位的分别是鲍曼不动杆菌、嗜麦芽窄食单胞菌、铜绿假单胞菌、肺炎克雷伯菌、产吲哚黄杆菌、阴沟肠杆菌；革兰阳性球菌主要是金黄色葡萄球菌.所分离菌株均不同程度表现多重耐药.结论 VAP的主要病原菌为革兰阴性杆菌,常为多重耐药的致病菌,临床医师应根据病原菌学及抗菌药物敏感性资料,及时选择合理的抗生素控制感染,延缓耐药菌株的产生.
목적 분석아원호흡궤상관성폐염(VAP)적병원학특점급내약정황.방법 대아원종합중증감호실화호흡중증감호실2011년1월지2012년8월진단위VAP적44례환자병원학자료진행회고성분석.결과 44례환자지기관분비물배양획득치병균83주,기중혁란음성간균63주,점75.9％；혁란양성구균14주,점16.9％；진균6주,점7.2％.혁란음성간균중점전6위적분별시포만불동간균、기맥아착식단포균、동록가단포균、폐염극뢰백균、산신타황간균、음구장간균；혁란양성구균주요시금황색포도구균.소분리균주균불동정도표현다중내약.결론 VAP적주요병원균위혁란음성간균,상위다중내약적치병균,림상의사응근거병원균학급항균약물민감성자료,급시선택합리적항생소공제감염,연완내약균주적산생.
Objective To investigate the distribution and drug resistance of pathogens from ventilator-associated pneumonia (VAP) in general intensive care unit (GICU) and respiratory intensive care unit(RICU).Methods Etiological data of 44 patients who were diagnosed as VAP from January 2011 to August 2012 in GICU and RICU were analyzed retrospectively.Results A total of 83 pathogens were isolated.63 strains (75.9％) were gram-negative bacillus,the main bacteria of which were Acinetobacter baumannii,Stenotrophomonas maltophilia,Pseudomonas aeruginosa,Klebsiella pneumoniae,Flavobacterium indologenes,and Enterobacter cloacae.14 strains (16.9％) were grampositive coccus,the main bacteria of which was Staphylococcus aureus.Six fungi strains were isolated (7.2％).The strains isolated were multidrug resistant and had high resistance rate.Conclusions The main bacterium in patients with VAP is gram-negative bacillus,which has higher resistance to common antibiotics.According to the data of the pathogens and antibiotic susceptibility,we can select antibiotics reasonably to control the infection and delay the emergency of new drug-resistant bacteria.