摘要
目的:研究呼吸机相关肺炎(VAP)患者的临床和常用抗生素的敏感性。方法:对2000年7月至2003年12月本院1 CU病房40例VAP病人进行回顾性分析。结果:VAP死亡病人达57.50％,MODS、休克、呼吸衰竭和电解质、酸碱平衡失调病人居多。138株病原菌以革兰阴性菌为主(88株)占63.77％,革兰阳性菌(25株)占18.12%,真菌(25株)占18.12％,混合菌株占37.68％。革兰阴性菌以铜绿假单胞菌、肺炎克雷伯菌(23/88株,占26.14％和20/88株,占22.72％)为主,革兰阳性菌以金黄色葡萄球菌(19/25株,占76.00％)为主,真菌以白假丝酵母菌(15/25株,占60.00％)为主。铜绿假单胞菌对头孢他啶和阿米卡星敏感率较高,分别为60.87％和52.17％,肺炎克雷伯菌、产气肠杆菌和鲍氏不动杆菌对亚胺培南/两司他丁的敏感率最高(70.00％-80.00％)。结论:VAP以革兰阴性菌为主,对VAP治疗要慎用第三代头孢菌素,合理选择敏感的抗生素。
Objective: To study clinic and sensitivity of antibiotics in ventilator-associated pneumonia(VAP). Methods: 40 cases patients in VAP from July 2000 to December 2003 were analyzed retrospectively. Results: 57.50% patients in VAP were dead.The majority of patients were MODS,shock, respiratory failure and electrolyte acid-base imbalance.88 strains were Gram-negative bacteria (63.77%), 25 strains were Gram-positive bacteria (18.12%) and 25 strains were fungi (18.12%) in all 138 pathogenic bacteria. Mixing strains were 37.68%. Pseudomonas aeruginosa and Klebsiella pneumoniae was the major one (26.14%, 22.72%) in Gram-negative bacteria. In Gram-positive bacteria Staphylococcus aureus was most prominent (76.00%) and Candida albicans was the main type of fungi (60.00%). The sensitivityof Pseudomonas aeruginosa to CAZ and AMK were 60.87% and 52.17%. The sensitivity of Gram-negative bacteria to Emipenem were 70.00-80.00%. Conclusions: Gram-negative bacteria were prominent in VAP, it is important to select rationally sensitive antibiotics..
出处
《抗感染药学》
2004年第1期24-25,27,共3页
Anti-infection Pharmacy
关键词
呼吸机相关肺炎
病原菌
敏感性
ventilator-associated pneumonia
pathogenic bacteria
sensitivity
