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目的分析新生儿呼吸机相关性肺炎(VAP)的病原菌分布及耐药性,为合理制定抗感染治疗方案提供客观依据。方法选取2013年1月-2014年12月在新生儿重症监护病房(NICU)住院治疗发生VAP的新生儿60例作为研究对象,采集新生儿痰液标本进行培养,应用全自动微生物鉴定系统进行病原菌鉴定,应用K-B纸片扩散法进行药敏试验,应用WHONET 5.3软件对药敏结果进行统计分析。结果 60例VAP新生儿送检标本培养出病原菌45株,阳性检出率为75.0%,检出的病原菌均为革兰阴性菌,以肺炎克雷伯菌、大肠埃希菌、鲍氏不动杆菌检出最多,分别占31.1%、28.9%和20.0%,3种病原菌对临床常用抗菌药物的耐药性均较高,其中肺炎克雷伯菌、大肠埃希菌对多数头孢菌素类抗菌药物的耐药率均达到100.0%,对环丙沙星、阿米卡星等抗菌药物均较敏感。结论新生儿VAP的病原菌分布和耐药性均具有一定的特征,应根据监测结果选用敏感抗菌药物进行治疗,以避免加重病原菌耐药,提高治愈率。
Objective To analyze the distribution and drug resistance of pathogens in neonatal ventilator-associated pneumonia (VAP) and provide an objective basis for the rational formulation of anti-infective therapy. Methods From January 2013 to December 2014, 60 neonates with VAP who were hospitalized in neonatal intensive care unit (NICU) were enrolled in this study. Neonatal sputum samples were collected for culture. The samples were collected by automatic microbe identification system Identification, the application of KB disk diffusion method for susceptibility testing, the use of WHONET 5.3 software for drug susceptibility results for statistical analysis. Results A total of 45 pathogenic bacteria were detected in 60 cases of VAP newborn, the positive rate was 75.0%. The pathogens detected were Gram-negative bacteria, Klebsiella pneumoniae, Escherichia coli, Bacillus detected the most, accounting for 31.1%, 28.9% and 20.0% respectively. The three pathogens had higher resistance to commonly used antibiotics in clinical practice. Among them, Klebsiella pneumoniae and Escherichia coli were most resistant to cephalosporins Drug resistance rates reached 100.0%, ciprofloxacin, amikacin and other antibiotics are more sensitive. Conclusion Neonatal VAP pathogens distribution and drug resistance have certain characteristics, should be based on the monitoring results of the selection of sensitive antimicrobial drugs for treatment, in order to avoid aggravating pathogen resistance and improve the cure rate.