摘要
目的探究VAP(呼吸机相关性肺炎)的痰培养细菌分布情况与细菌耐药性情况。方法方便选取该院2018年1月—2019年6月收治的98例VAP患者为研究对象,所有患者均在入院24 h之内对痰标本进行留取,同时对机械通气48 h之后出现肺炎情况的痰液标本进行收集,均行药物敏感试验与病原菌培养,分析不同时期细菌分布情况以及细菌耐药性情况。结果98份痰标本中共培养出151株致病菌,其中住院24 h内共培养出61株,发现VAP之后共培养出90株,病原菌检出率均于前3位的分别为鲍曼不动杆菌,占27.80%,铜绿假单胞菌,占25.20%,肺炎克雷伯菌,占25.20%;鲍曼不动杆菌对头孢唑林钠的耐药性最高,为100.00%,铜绿假单胞菌对氨苄西林、头孢唑林钠的耐药性均为100.00%,同时对氨苄西林/舒巴坦也具有较高耐药性,为73.68%,肺炎克雷伯杆菌对氨苄西林的耐药性最高,为94.74%,其次为头孢唑林钠,为78.95%。结论革兰阴性菌为VAP主要致病菌,对抗菌药物具有较高耐药性,临床需针对性的选择抗菌药物对患者进行治疗,以此来将临床治愈率提高。
Objective To explore the distribution of bacteria in sputum culture of VAP(Ventilator Associated Pneumonia)and the status of bacterial resistance.Methods Convenient select a total of 98 VAP patients who were admitted to the hospital from January 2018 to June 2019 were selected as the research subjects.All patients were collected within 24 h of admission to the hospital,and sputum samples that developed pneumonia after 48 h of mechanical ventilation were collected.The specimens were collected,and the drug susceptibility test and pathogen culture were performed to analyze the distribution of bacteria and the resistance of bacteria in different periods.Results A total of 151 pathogenic bacteria were cultured in 98 sputum specimens,of which 61 were co-cultured within 24 h of hospitalization,and 90 were co-cultured after the discovery of VAP.The detection rates of pathogenic bacteria were among the top three Acinetobacter baumannii,accounting for 27.80%,Pseudomonas aeruginosa,accounting for 25.20%,Klebsiella pneumoniae,accounting for 25.20%;Acinetobacter baumannii had the highest resistance to cefazolin sodium,100.00%,Pseudomonas aeruginosa resistance to ampicillin and cefazolin sodium was 100.00%,and the resistance to ampicillin/sulbactam was also higher,being 73.68%.Klebsiella pneumoniae had the highest resistance to ampicillin,being 94.74%,followed by cefazolin sodium,which was 78.95%.Conclusion Gram-negative bacteria are the main pathogenic bacteria of VAP and have high resistance to antibacterial drugs.It is necessary to select antibacterial drugs to treat patients in order to improve the clinical cure rate.
作者
祁安宁
QI An-ning(Department of Laboratory Medicine,People's Hospital of Liuhe District,Nanjing,Jiangsu Province,211500 China)
出处
《中外医疗》
2020年第28期183-185,共3页
China & Foreign Medical Treatment
关键词
呼吸机相关性肺炎
痰培养
细菌分布情况
耐药性
Ventilator-associated pneumonia
Sputum culture
Bacterial distribution
Drug resistance
