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目的探讨新生儿呼吸机相关性肺炎(VAP)的发病率、高危因素、病原学特点、耐药性及预防措施,为新生儿VAP的防治提供一定的理论依据。方法选取我院新生儿病房自2009年1月至2012年1月所收治的64例VAP新生儿作为研究对象,药敏质量监控采用金黄色葡萄球菌(ATCC 25923)、大肠埃希氏菌(ATCC 25922)、质控菌株铜绿假单胞菌(ATCC 27853)进行。结果 64例新生儿标本检出病原菌36株,阳性率56.2%,病原菌前5位从后到前为嗜麦芽窄食假单胞菌、溶血葡萄球菌、大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌;5例(13.9%)真菌,7例(19.4%)革兰阳性菌,24例(66.7%)革兰阴性菌。结论临床上以革兰阴性菌最常见,为了大幅度降低多重耐药菌和混合感染的发生,应努力做到早治疗、早预防,并及时监测。
Objective To investigate the incidence, risk factors, etiological characteristics, drug resistance and preventive measures of neonatal ventilator-associated pneumonia (VAP) and to provide some theoretical basis for the prevention and treatment of neonatal VAP. Methods Sixty-four neonates with VAP who were admitted to neonatal wards of our hospital from January 2009 to January 2012 were selected as study objects. The drug susceptibility monitoring was performed using Staphylococcus aureus (ATCC 25923), Escherichia coli (ATCC 25922), the control strain Pseudomonas aeruginosa (ATCC 27853). Results Sixty-four newborns were detected as pathogenic bacteria with a positive rate of 56.2%. The top five pathogens were PMS, PSB, Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa; 5 fungi (13.9%), 7 Gram-positive bacteria (19.4%) and 24 Gram-negative bacteria (66.7%). Conclusion Gram-negative bacteria are the most common in clinical practice. In order to reduce the incidence of multi-drug resistant bacteria and mixed infections, early treatment, early prevention and timely monitoring should be endeavored.