摘要
目的分析呼吸机相关性肺炎的病原学特点以及耐药性。方法回顾120例接受有创机械通气治疗后发生呼吸机相关性肺炎患者的临床资料,采用微生物全自动分析仪鉴定病原菌,采用纸片扩散法进行药敏性试验。结果120例呼吸机相关性肺炎患者下呼吸道分泌物标本中共分离出病原菌199株,79例为混合感染,其中以革兰阴性菌为主(占61.31%),包括肺炎克雷伯杆菌、铜绿假单胞菌、鲍曼不动杆菌等;革兰氏阳性菌占26.63%,主要为金黄色葡萄球菌。肺炎克雷伯杆菌、铜绿假单胞菌、鲍曼不动杆菌对多黏菌素B、美罗培南、亚胺培南较为敏感,其耐药率在20%以下;金黄色葡萄球菌对青霉素、头孢唑林、亚胺培南的耐药率较高,在75%以上,对阿莫西林、阿奇霉素、万古霉素敏感。结论呼吸机相关性肺炎的致病菌种类较多,其以革兰氏阴性菌为主。各类病原菌均具有一定的耐药性。
Objective To analyze the pathogenic bacteria and drug sensitivity of ventilator-associated pneumonia.Methods The clinical data of 120 patients who developed ventilator-associated pneumonia after receiving invasive mechanical ventilation were reviewed.The pathogenic bacteria were isolated using an automatic microbial identification analyzer,and drug sensitivity tests were performed using the disk diffusion method.Results A total of 199 pathogenic bacteria were isolated from respiratory secretion samples from 120 patients with ventilator-associated pneumonia.Of these,79 cases showed mixed infections,with predominantly Gram-negative bacteria(61.31%),mainly Klebsiella pneumoniae,Pseudomonas aeruginosa,Acinetobacter baumannii;Gram-positive bacteria accounted for 26.63%,mainly Staphylococcus aureus.Klebsiella pneumoniae,Pseudomonas aeruginosa,Acinetobacter baumannii were more sensitive to polymyxin B,meropenem,and imipenem,and their resistance rate was below 20%.Staphylococcus aureus had a high resistance rate(above 75%)to penicillin,cefazolin,and imipenem,and was sensitive to amoxicillin,azithromycin,and vancomycin.Conclusions Ventilator-associated pneumonia was associated with a wide variety of pathogens,which were mainly Gram-negative bacteria.Antibiotic resistance was present in all pathogenic bacteria.
作者
乔锦霞
赵学卫
陈巧仙
QIAO Jinxia;ZHAO Xuewei;CHEN Qiaoxian(Department of Pharmacy,the Second Hospital of Pujiang,Pujiang 322204,China;Department of Laboratory,the Second Hospital of Pujiang,Pujiang 322204,China)
出处
《健康研究》
CAS
2021年第1期43-46,共4页
Health Research
关键词
呼吸机相关性肺炎
病原菌
耐药性
ventilator-associated pneumonia
pathogenic bacteria
drug resistance
