呼吸机相关性肺炎的常见病原菌耐药性分析

目的:探讨呼吸机相关性肺炎(VAP)的常见病原菌并分析其耐药性,为临床治疗提供依据。方法:选取我院收治的135例VAP患者的临床资料,分析其病原菌分布以及抗菌药物的耐药性。结果:135例患者中共分离出183株病原菌,其中革兰氏阴性菌135株(占73.77%),革兰氏阳性细菌33株(占18.03%),真菌15株(占8.20%)。革兰氏阴性菌主要为鲍曼不动杆菌,占35.52%,革兰氏阳性细菌主要为金黄色葡萄球菌,占9.84%,革兰阳性菌无一对万古霉素耐药,除了米诺环素总耐药率为42.42%外,其余病原菌对于常用的药物总耐药率均大于60.0%,革兰阴性菌普遍存在多药耐药现象。结论:引起VAP患者感染的主要致病菌为革兰阴性菌群,且存在严重的多重耐药现象,在临床上应加强对VAP疾病的预防和控制,合理应用抗菌药物。

Analysis on the Common Pathogenic Bacteria of Ventilator Associated Pneumonia and the Drug Resistance*

Objective:To study the common pathogenic bacteria of ventilator associated pneumonia (VAP) and to analyze its drug resistance, so as to provide data for clinical treatment.Methods:The clinical data of 135 patients with VAP in our hospital were retrospectively analyzed. Their pathogenic bacteria distribution and antimicrobial resistance were investigated.Results:Totally, 183 strains of pathogenic bacteria was isolated from 135 patients. Of them, there were 135 strains (73.77%) of gram-negative bacteria, 33 (18.03%) strains of grampositive bacteria, 15 strains (8.20%) of fungi. Gram-negative bacteria mainly included (35.52%). And gram-positive bacteria mainly included (9.84%). There was no vancomycin resistance among gram positive bacteria. Except the total resistance percentage to minocycline was 42.42%, the total resistance to commonly drugs in rest of the pathogenic bacteria all were greater than 60.0%. Gram-negative bacteria had a widespread multi-resistant phenomenon.Conclusion:The main pathogenic bacteria causing infections in VAP patients were gram-negative bacteria, and there were serious multi-drug resistance phenomenon. We should strengthen the prevention and control of VAP and make reasonable use of the antimicrobial agents.