中国实用医刊
中國實用醫刊
중국실용의간
CENTRAL PLAINS MEDICAL JOURNAL
2013年
12期
16-18
,共3页
新生儿%呼吸机相关性肺炎%临床分析%预防对策
新生兒%呼吸機相關性肺炎%臨床分析%預防對策
신생인%호흡궤상관성폐염%림상분석%예방대책
Neonatal%Ventilator-associated pneumonia%Clinical analysis%Prophylactic strategy
目的 探讨新生儿重症监护病房(NICU)中呼吸机相关性肺炎(VAP)的病原菌组成及相关因素,为临床防治提供依据.方法 分析66例NICU确诊的VAP患儿的临床资料及下呼吸道分泌物细菌培养的结果.结果 VAP的发生率为50.77％;66例患儿共检出91株致病菌,其中革兰阴性菌69株(75.82％),革兰阳性菌13株(14.29％),真菌9株(9.89％)；铜绿假单胞菌、金黄色葡萄球菌、肺炎克雷伯杆菌和白色念珠菌是VAP的主要致病菌；药敏结果显示感染菌株多重耐药,肠杆菌科革兰阴性菌对碳青霉烯类抗生素无一耐药,非发酵菌革兰阴性菌对常用的抗生素均具有较高的耐药性,革兰阳性菌对万古霉素无一耐药.结论 NICU内VAP病原菌以革兰阴性菌为主,真菌比例较高,混合致病菌感染比例高；积极预防和治疗可以有效降低VAP的发生.
目的 探討新生兒重癥鑑護病房(NICU)中呼吸機相關性肺炎(VAP)的病原菌組成及相關因素,為臨床防治提供依據.方法 分析66例NICU確診的VAP患兒的臨床資料及下呼吸道分泌物細菌培養的結果.結果 VAP的髮生率為50.77％;66例患兒共檢齣91株緻病菌,其中革蘭陰性菌69株(75.82％),革蘭暘性菌13株(14.29％),真菌9株(9.89％)；銅綠假單胞菌、金黃色葡萄毬菌、肺炎剋雷伯桿菌和白色唸珠菌是VAP的主要緻病菌；藥敏結果顯示感染菌株多重耐藥,腸桿菌科革蘭陰性菌對碳青黴烯類抗生素無一耐藥,非髮酵菌革蘭陰性菌對常用的抗生素均具有較高的耐藥性,革蘭暘性菌對萬古黴素無一耐藥.結論 NICU內VAP病原菌以革蘭陰性菌為主,真菌比例較高,混閤緻病菌感染比例高；積極預防和治療可以有效降低VAP的髮生.
목적 탐토신생인중증감호병방(NICU)중호흡궤상관성폐염(VAP)적병원균조성급상관인소,위림상방치제공의거.방법 분석66례NICU학진적VAP환인적림상자료급하호흡도분비물세균배양적결과.결과 VAP적발생솔위50.77％;66례환인공검출91주치병균,기중혁란음성균69주(75.82％),혁란양성균13주(14.29％),진균9주(9.89％)；동록가단포균、금황색포도구균、폐염극뢰백간균화백색념주균시VAP적주요치병균；약민결과현시감염균주다중내약,장간균과혁란음성균대탄청매희류항생소무일내약,비발효균혁란음성균대상용적항생소균구유교고적내약성,혁란양성균대만고매소무일내약.결론 NICU내VAP병원균이혁란음성균위주,진균비례교고,혼합치병균감염비례고；적겁예방화치료가이유효강저VAP적발생.
Objective To investigate the compose and correlative factors of pathogens leading to ventilator-associated pneumonia(VAP) in neonatal intensive care units (NICU),so as to provide evidences for clinical therapy.Methods The clinical data and the results of bacteria culture from the secretion of lower respiratory tracts of 66 cases of VAP in NICU were analyzed.Results The VAP incidence rate was 50.77％.91 stains of pathogens were separated from 66 patients.In these pathogens,there were 69 strains of gram negative bacteria,13 strains of gram positive bacteria and 9 strains of fungi.The main pathogens of VAP included pseudomonas aeruginosa,staphylococcus,klebsiella pneumoniae,candidiasis albicans.Susceptibility test results showed that most pathogens were multi-drug resistant.No enterobacteriaceae had drug-resistance to carbopenems.Nonfermenters had a high drug-resistance to many widely-used antibiotics.Gram positive bacteria had no drug-resistance to vancomysin.Conclusions The main pathogens of VAP in NICU were gram negative bacteria.The rate of fungus and multiple bacterial infections was high.The combined treatment was necessary constitution for control of VAP.
