中国冶金工业医学杂志

急诊ICU呼吸机相关性肺炎的病原学分析

作者：罗涛

分类号：R 563文献标志码：A文章编号：1005-5495(2012)06-0639

出版年,卷(期):页码：2012,29(6):639-640

摘要：

摘要：目的探讨急诊ICU呼吸机相关性肺炎的病原学特点。方法以2011年1月至2012年1月入住我院急诊ICU应用呼吸机人工辅助呼吸且被诊断为呼吸机相关性肺炎的23例患者为观察对象，使用一次性无菌吸痰管从患者气管插管内吸取痰液标本，送实验室培养后行菌种鉴定及药敏试验。结果共检出病原菌70株，其中革兰阴性菌48株（占686%），排名依次为鲍曼不动杆菌16株、铜绿假单胞菌14株、大肠埃希菌6株、嗜麦芽窄食单胞菌6株、肺炎克雷白菌3株、其他革兰阴性菌3株；革兰阳性菌17株（占243%），排名依次为金黄色葡萄球菌12株、溶血葡萄球菌2株、其他革兰阳性菌3株；真菌5株（占71%）。大多数革兰阴性菌对亚胺培南及美罗培南敏感，但嗜麦芽窄食单胞菌对亚胺培南及美罗培南完全耐药。结论急诊ICU呼吸机相关性肺炎的主要致病菌为革兰阴性菌，多数革兰阴性菌对亚胺培南及美罗培南敏感，临床上应依据药敏试验结果选择敏感抗生素治疗呼吸机相关性肺炎。

Abstract: Objective To investigate etiological feature of ventilator\|associated pneumonia in emergency ICU wardMethods23 patients with ventilator\|associated pneumonia in emergency ICU ward were chosen as the research object from January 2011 to January 2012Sputum draw from intubation were underwent strain identification and sensitivity testing in laboratoryResults70 pathogens were detected48 Gram\|negative bacilli(686%),including 16 Acinetobacter baumannii,14 Pseudomonas aeruginosa,6 Escherichia coli,6 Stenotrophomonas maltophilia Aeromonas,3 Klebsiella pneumoniae,3 other gram\|negative bacteriastrains;17 Gram\|positive bacteria(243%),including 12 Staphylococcus aureus,2 Staphylococcus haemolyticus,3 other Gram\|positive bacteria;5 fungi(71%)Most Gram\|negative bacteria were sensitive to imipenem and meropenem,but Stenotrophomonas maltophilia Aeromonas fully resistanted to imipenem and meropenemConclusionPathogens of the ventilator\|associated pneumonia is mainly of Gram\|negative bacilli,and the majority of gram\|negative bacilli are sensitive to imipenem and meropenemSensitive antibiotic should be chosen depending on susceptibility testing

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参考文献：

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