呼吸机相关肺炎患者病原学特点及影响因素分析

发布时间：2018-04-30 10:09

  本文选题：呼吸机相关肺炎 + 病原学特点　； 参考：《中华医院感染学杂志》2017年21期

【摘要】：目的回顾性分析呼吸机相关肺炎病原学特点及影响因素,旨在为临床提供参考。方法选取医院2013年9月-2016年9月收治的ICU应用呼吸机患者600例,统计呼吸机相关肺炎发生率,分析感染病原菌分布及耐药情况,分析呼吸机相关肺炎相关影响因素。结果共发生呼吸机相关肺炎78例,发生率为13.00%;78例呼吸机相关肺炎患者共培养出病原菌86株,其中革兰阴性菌63株、占73.26%,革兰阳性菌19株、占22.09%,真菌4株、占4.65%;革兰阴性菌对头孢唑林、头孢噻肟、头孢他啶、庆大霉素耐药率较高,对美罗培南、莫西沙星、环丙沙星、阿米卡星耐药率较低;革兰阳性菌对青霉素G、红霉素、环丙沙星、左氧氟沙星耐药率较高,对万古霉素、磺胺甲VA唑/甲氧倫啶耐药率较低;年龄60岁、机械通气时间5d、气管切开、APACHE II评分≥15分、使用制酸剂为呼吸机相关肺炎独立危险因素。结论引起呼吸机相关肺炎发生的危险因素较多,临床上需针对危险因素进行预防,同时进行病原学分析,合理应用抗菌药物,从而有效降低呼吸机相关性肺炎发病率。
[Abstract]:Objective to analyze the etiological characteristics and influencing factors of ventilator-associated pneumonia in order to provide reference for clinical practice. Methods from September 2013 to September 2016, 600 patients with ICU ventilator were selected to analyze the incidence of ventilator-associated pneumonia, the distribution of pathogenic bacteria and drug resistance, and the influencing factors of ventilator-associated pneumonia. Results A total of 78 cases of ventilator-associated pneumonia were found, and the incidence was 13.00%. A total of 86 strains of pathogenic bacteria were cultured in 78 patients with ventilator-associated pneumonia. Among them, 63 strains of gram-negative bacteria (73.26%), 19 strains of gram-positive bacteria (22.09%), and 4 strains of fungi. The resistance rate of Gram-negative bacteria to cefazolin, cefotaxime, ceftazidime, gentamicin was higher than that of meropenem, moxifloxacin, ciprofloxacin and amikacin. The resistance rate of ciprofloxacin to levofloxacin was higher than that to vancomycin and sulfamethoxazole / methoxylamidine, the age was 60 years old, the mechanical ventilation time was 5 days, and the Apache II score of tracheotomy was 鈮，

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