CAJ | 학술논문

目的分析并比较综合性重症监护病房(CICU)和急诊重症监护病房(EICU)早发性呼吸机相关性肺炎(EOP)患者下呼吸道分离的病原菌分布及多重耐药菌(MDRB)比例.方法选择CICU和EICU接受有创机械通气治疗的患者,采用一次性无菌痰标本采集管和无菌集痰器或纤维支气管镜经气管插管或气管切开套管采集下呼吸道分泌物标本,即时送检进行细菌培养及药敏试验,并对两组患者病原菌构成及MDRB比例进行比较.结果在CICU中EOP发生率12.8%,MDRB比例为50.4%,非发酵菌属及念珠菌属是主要的病原菌;而在EICU中,EOP发生率7.9%,MDRB比例仅为8.3%,表皮葡萄球菌、金黄色葡萄球菌、大肠埃希菌是主要病原菌.两组患者MDRB发生率的差异具有统计学意义(P<0.01).结论呼吸机相关性肺炎(VAP)的病原菌类型是由多种因素综合决定的,而不是由VAP发生时间的早晚所决定的.
목적분석병비교종합성중증감호병방(CICU)화급진중증감호병방(EICU)조발성호흡궤상관성폐염(EOP)환자하호흡도분리적병원균분포급다중내약균(MDRB)비례.방법선택CICU화EICU접수유창궤계통기치료적환자,채용일차성무균담표본채집관화무균집담기혹섬유지기관경경기관삽관혹기관절개투관채집하호흡도분비물표본,즉시송검진행세균배양급약민시험,병대량조환자병원균구성급MDRB비례진행비교.결과재CICU중EOP발생솔12.8%,MDRB비례위50.4%,비발효균속급념주균속시주요적병원균;이재EICU중,EOP발생솔7.9%,MDRB비례부위8.3%,표피포도구균、금황색포도구균、대장애희균시주요병원균.량조환자MDRB발생솔적차이구유통계학의의(P<0.01).결론호흡궤상관성폐염(VAP)적병원균류형시유다충인소종합결정적,이불시유VAP발생시간적조만소결정적.
Objective To investigate the distribution of pathogens and ratio of multidrug resistant bacteria (MDRB) sepa-rated from lower respiratory tract of early-onset ventilator-associated pneumonia (VAP) patients in comprehensive intensive care unit (CICU) and emergency intensive care unit (EICU). Methods The lower respiratory tract secretions specimens of EOP pa-tients in CICU and EICU were col ected by using disposable sterile sputum specimen col ection tubes and sterile sputum set or fiber bronchoscope through the endotracheal tube or tracheostomy tube from July 2008 to December 2011. The specimens were immediately sent for bacterial culture and sensitivity test; the distribution of pathogens and ratio of MDRB were compared be-tween two groups. Results In CICU the Gram-negative bacteria, especially non-fermentative bacteria were the main pathogens, the ratio of MDRB was 50.4%;in EICU the Gram-positive bacteria, especial y Staphylococcus epidermidis, Staphylo-coccus aureus, Escherichia coli were the main pathogens, the ratio of MDRB was 8.3%. There were significant differences in the distribution characteristics and MDRB ratio of pathogens between two groups. Conclusion The pathogens isolated from VAP patients are determined by the various factors, not the type of VAP.