目的了解医院重症监护室呼吸机相关肺炎病原菌及其耐药性发展趋势,为临床科学用药提供参考。方法通过前瞻性目标监测,对某驻军医院重症监护室(ICU)住院机械通气病人呼吸机相关肺炎(VAP)病原菌进行了监测与分析。结果该医院ICU在2010-2011年期间实施机械通气治疗的病人106例,发生VAP患者48例,发生率为45.3%。从48例VAP患者标本中共分离病原菌85株,其中革兰阴性杆菌占75.29%,革兰阳性球菌占22.35%。此两类病原菌中,以不动杆菌、铜绿假单胞菌和表皮葡萄球菌所占比例最高,对氨苄西林耐药最严重。结论该医院ICU机械通气病人VAP发病率较高,其耐药趋势呈多态性变化,根据药敏试验结果选用抗菌药物至关重要。 Objective To understand the pathogens of ventilator-associated pneumonia in hospital intensive care unit and its development trend of drug resistance, and to provide a reference for clinical scientific medication. Methods By means of prospective target monitoring, pathogenic bacteria of Ventilator Associated Pneumonia (VAP) in hospitalized patients with mechanical ventilation in an intensive care unit of a military hospital were monitored and analyzed. Results In the ICU of the hospital during the period of 2010-2011, 106 patients were treated with mechanical ventilation, 48 patients developed VAP, the incidence was 45.3%. A total of 85 pathogenic bacteria were isolated from 48 VAP patients, of which Gram-negative bacilli accounted for 75.29% and Gram-positive cocci accounted for 22.35%. The two types of pathogens, the Acinetobacter, Pseudomonas aeruginosa and Staphylococcus epidermidis accounted for the highest proportion of the most resistant to ampicillin. Conclusion The incidence of VAP in ICU patients with mechanical ventilation is high, and the trend of drug resistance is polymorphic. It is very important to select antimicrobial drugs according to the result of drug susceptibility test.