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目的了解医院综合ICU呼吸机相关性肺炎(VAP)病原菌临床分布特点及其耐药性。方法采用回顾性调查方法,某医院重症监护病房(ICU)住院病人感染VAP情况及病原学检测结果进行了调查。结果在调查期间从该医院住院病人感染VAP痰标本中共分离出病原菌487株,其中革兰阴性菌构成比为55.24%,革兰阳性球菌构成比为37.37%,真菌构成比为7.39%。居前4位的是肺炎克雷伯菌、大肠埃希菌、铜绿假单胞菌和金黄色葡萄球菌。VAP病原菌对常用抗菌药物均高度耐药,未检出耐万古霉素革兰阳性球菌和耐亚胺培南的肠道杆菌。结论综合ICU病房内VAP感染病原菌主要是革兰阴性杆菌,混合感染比例高,多数病原菌严重耐药。
Objective To understand the clinical characteristics and drug resistance of pathogenic bacteria associated with ventilator-associated pneumonia (VAP) in the hospital ICU. Methods A retrospective survey was conducted to investigate the prevalence of VAP in hospital intensive care unit (ICU) and the results of pathogenic tests. Results During the investigation, 487 pathogenic bacteria were isolated from the inpatients infected with VAP in the hospital. The gram-negative bacteria composition ratio was 55.24%, the gram-positive coccus constituent ratio was 37.37% and the fungal constituent ratio was 7.39%. The top 4 are Klebsiella pneumoniae, Escherichia coli, Pseudomonas aeruginosa and Staphylococcus aureus. VAP pathogens are highly resistant to commonly used antimicrobial agents, vancomycin-resistant Gram-positive cocci and imipenem-resistant enterobacteria are not detected. Conclusion The pathogens of VAP infection in ICU ward are mainly Gram-negative bacilli. The proportion of mixed infection is high, and most pathogens are highly drug-resistant.