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目的:呼吸机相关性肺炎(VAP)发病率逐年增高,致残率、致死率也呈上升趋势.分析NICU中新生儿(VAP)的病原菌分布以及耐药性,为抗生素治疗VAP的提供科学依据。方法:回顾分析2001年1月至2007年1月重庆医科大学儿童医院新生儿科89例新生儿VAP患儿临床资料、痰培养及药敏结果。结果:89例VAP患者共分离病原菌155株,革兰阴性杆菌占80%,革兰阳性菌占12.3%,真菌占7.7%。病原菌以肺炎克雷伯杆菌(27.1%),鲍曼不动杆菌0、铜绿假单胞菌和大肠埃希菌为主要致病菌。分离的细菌除对泰能较敏感外,对其他抗生素均有不同程度耐药。结论:VAP的病原菌构成以革兰阴性杆菌为主且呈现出多重耐药现象,适当的最初经验性抗菌治疗应遵依据于本地区最新的病原学和耐药性的监测结果。
OBJECTIVE: The incidence of ventilator-associated pneumonia (VAP) is increasing year by year, and the morbidity and mortality are also on the rise.To analyze the distribution and drug resistance of neonatal (VAP) pathogens in NICU and to provide a scientific basis for antibiotic treatment of VAP . Methods: The clinical data, sputum culture and drug susceptibility results of 89 newborns with VAP from January 2001 to January 2007 in Children’s Hospital of Chongqing Medical University were retrospectively analyzed. Results: A total of 155 pathogens were isolated from 89 VAP patients. Gram-negative bacilli accounted for 80%, Gram-positive bacteria accounted for 12.3% and fungi accounted for 7.7%. Pathogenic bacteria Klebsiella pneumoniae (27.1%), Acinetobacter baumannii 0, Pseudomonas aeruginosa and Escherichia coli as the main pathogens. In addition to the separation of bacteria more sensitive to Thailand, the other antibiotics have varying degrees of resistance. CONCLUSIONS: The pathogens of VAP are mainly Gram-negative bacilli and show multiple drug resistance. Appropriate initial antimicrobial treatment should follow the latest etiological and drug resistance monitoring results in the region.