| 呼吸机相关性肺炎的病原学特点及防治 | |
| 延峰 ; 傅宜静 ; 骆文玲 ; 崔蓉 ; 王瑞琴 ; YAN Feng ; FU Yi-jing ; LUO Wen-ling ; CUI Rong ; WANG Rui-qin | |
| 2010-06-09 ; 2010-06-09 | |
| 关键词 | 呼吸机相关性肺炎 呼吸重症监护病房 病原菌 耐药 抗菌药物用量 Ventilator-associated pneumonia Respiratory intensive care unit Pathogens Resistance Dosage of antibiotics R563.1 |
| 其他题名 | Prevention and Treatment of Ventilator-associated Pneumonia:Their Characteristics |
| 中文摘要 | 目的探讨呼吸重症监护病房(RICU)呼吸机相关性肺炎(VAP)常见病原菌种类及耐药性,并对首位病原菌的耐药性与抗菌药物用量间的关系进行分析。方法对2005年1月-2008年1月RICU诊断为VAP 43例患者所分离407株菌的分布、耐药性进行了回顾性调查分析,并对呼吸科3年中7种抗菌药物的年用量与这些药物对VAP首位病原菌的耐药性进行统计分析。结果前7位病原菌依次为铜绿假单胞菌、肺炎克雷伯菌、金黄色葡萄球菌、阴沟肠杆菌、真菌、嗜麦芽寡养单胞菌、鲍氏不动杆菌;铜绿假单胞菌对头孢他啶的耐药率>50.0%且逐年增加,对氨基糖苷类的耐药率<30.0%,耐药率较低依次为环丙沙星和阿米卡星,对β-内酰胺类耐药率逐年降低;亚胺培南、头孢他啶、阿米卡星、环丙沙星、氧氟沙星对铜绿假单胞菌的耐药率和用药频度(DDDs)呈显著正相关(r=1,P<0.01),阿莫西林/克拉维酸、哌拉西林的年用量与耐药率无相关性。结论在RICU中VAP以革兰阴性菌为主,但革兰阳性菌感染呈上升趋势,积极治疗原发病,尽量缩短机械通气时间,合理使用抗菌药物,有利于防治VAP。; OBJECTIVE To analyze ventilator-associated pneumonia(VAP) in the respiratory intensive care unit(RICU) and the pathogens,antibiotic resistance and their relationship. METHODS From Jan 2005 to Jan 2008,43 VAP cases were diagnosed and 407 strains were isolated.The antibiotic resistance was retrospectively analyzed. RESULTS The former is seven Pseudomonas aeruginosa,Klebsiella pneumoniae,Staphylococcus aureus,Enterobacter cloacae,fungi,bacteria Pseudomonas maltophilia.P.aeruginosa(PAE) of resistance to ceftazidime rate> 50.0% and increased year by year,the rate of aminoglycoside resistance <30.0%,the resistance rate is lower ciprofloxacin(CIP) and the Arab-Israeli Mika Star(AMK),the β-lactam resistance rate decreased year by year.IPM,CAZ,AMK,CIP,OFL on P.aeruginosa resistance rates and drug use frequency(DDDs) for correlation analysis showed a significant positive correlation(r =1,P <0.01),AMC,PCP annual usage and resistance rate had no correlation. CONCLUSIONS VAP in the RICU is mainly induced by Gram-negative bacteria,but Gram-positive bacteria infections are on the rise,the positive treatment of primary disease,as far as possible to shorten the time of mechanical ventilation,and the rational use of antimicrobial agents,prevention and treatment all are in favor of VAP. |
| 语种 | 中文 ; 中文 |
| 内容类型 | 期刊论文 |
| 源URL | [http://hdl.handle.net/123456789/58916]  |
| 专题 | 清华大学 |
| 推荐引用方式 GB/T 7714 | 延峰,傅宜静,骆文玲,等. 呼吸机相关性肺炎的病原学特点及防治[J],2010, 2010. |
| APA | 延峰.,傅宜静.,骆文玲.,崔蓉.,王瑞琴.,...&WANG Rui-qin.(2010).呼吸机相关性肺炎的病原学特点及防治.. |
| MLA | 延峰,et al."呼吸机相关性肺炎的病原学特点及防治".(2010). |
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