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目的了解医院住院患者呼吸机相关肺炎(VAP)标本多重耐药菌(MDROs)分离结果及其感染相关因素。方法通过回顾性调查方法,对某医院重症医学科(ICU)实施气管插管或气管切开使用呼吸机的患者病原学标本检测结果进行统计分析。结果共调查接受机械通气患者997例,发生VAP患者120例,VAP的发病率为12.04%,千日感染率为11.14‰。从120例VAP患者送检标本中检出病原菌120株,含MDROs78株,构成比为65.00%。MDROs中以鲍曼不动杆菌、铜绿假单胞菌和金黄色葡萄球菌分居前3位。经分析发现,住院时间、呼吸机使用时间、长期使用抗菌药物以及GCS评分等因素对患者感染MDROs具有一定的相关性。结论该医院ICU患者VAP病原菌中有65%为MDROs菌株,长时间使用抗菌药物和使用呼吸机是导致患者感染MDROs的重要因素。
Objective To understand the isolation results of MDRs in hospitalized patients with ventilator associated pneumonia (VAP) and the related factors of infection. Methods A retrospective survey was conducted to analyze the results of pathogenic specimens of patients undergoing intubation or tracheotomy using a ventilator in a hospital intensive care unit (ICU). Results A total of 997 patients with mechanical ventilation were enrolled and 120 patients with VAP were enrolled. The incidence of VAP was 12.04% and the infection rate was 11.14 ‰. A total of 120 pathogens were detected from 120 specimens of VAP patients, including 78 strains of MDROs, with a ratio of 65.00%. In MDROs, Acinetobacter baumannii, Pseudomonas aeruginosa and Staphylococcus aureus were the top three. The analysis found that hospitalization time, ventilator time, long-term use of antimicrobial drugs and GCS score and other factors have some relevance to patients infected with MDROs. CONCLUSIONS: Sixty-five percent of VAP pathogens in ICU patients in this hospital are MDROs strains. Long-term use of antimicrobials and the use of ventilators is an important factor in patients with MDROs.