發(fā)布時(shí)間：2018-04-30 10:09

  本文選題：呼吸機(jī)相關(guān)肺炎 + 病原學(xué)特點(diǎn)��； 參考：《中華醫(yī)院感染學(xué)雜志》2017年21期

【摘要】：目的回顧性分析呼吸機(jī)相關(guān)肺炎病原學(xué)特點(diǎn)及影響因素,旨在為臨床提供參考。方法選取醫(yī)院2013年9月-2016年9月收治的ICU應(yīng)用呼吸機(jī)患者600例,統(tǒng)計(jì)呼吸機(jī)相關(guān)肺炎發(fā)生率,分析感染病原菌分布及耐藥情況,分析呼吸機(jī)相關(guān)肺炎相關(guān)影響因素。結(jié)果共發(fā)生呼吸機(jī)相關(guān)肺炎78例,發(fā)生率為13.00%;78例呼吸機(jī)相關(guān)肺炎患者共培養(yǎng)出病原菌86株,其中革蘭陰性菌63株、占73.26%,革蘭陽(yáng)性菌19株、占22.09%,真菌4株、占4.65%;革蘭陰性菌對(duì)頭孢唑林、頭孢噻肟、頭孢他啶、慶大霉素耐藥率較高,對(duì)美羅培南、莫西沙星、環(huán)丙沙星、阿米卡星耐藥率較低;革蘭陽(yáng)性菌對(duì)青霉素G、紅霉素、環(huán)丙沙星、左氧氟沙星耐藥率較高,對(duì)萬(wàn)古霉素、磺胺甲VA唑/甲氧倫啶耐藥率較低;年齡60歲、機(jī)械通氣時(shí)間5d、氣管切開(kāi)、APACHE II評(píng)分≥15分、使用制酸劑為呼吸機(jī)相關(guān)肺炎獨(dú)立危險(xiǎn)因素。結(jié)論引起呼吸機(jī)相關(guān)肺炎發(fā)生的危險(xiǎn)因素較多,臨床上需針對(duì)危險(xiǎn)因素進(jìn)行預(yù)防,同時(shí)進(jìn)行病原學(xué)分析,合理應(yīng)用抗菌藥物,從而有效降低呼吸機(jī)相關(guān)性肺炎發(fā)病率。
[Abstract]:Objective to analyze the etiological characteristics and influencing factors of ventilator-associated pneumonia in order to provide reference for clinical practice. Methods from September 2013 to September 2016, 600 patients with ICU ventilator were selected to analyze the incidence of ventilator-associated pneumonia, the distribution of pathogenic bacteria and drug resistance, and the influencing factors of ventilator-associated pneumonia. Results A total of 78 cases of ventilator-associated pneumonia were found, and the incidence was 13.00%. A total of 86 strains of pathogenic bacteria were cultured in 78 patients with ventilator-associated pneumonia. Among them, 63 strains of gram-negative bacteria (73.26%), 19 strains of gram-positive bacteria (22.09%), and 4 strains of fungi. The resistance rate of Gram-negative bacteria to cefazolin, cefotaxime, ceftazidime, gentamicin was higher than that of meropenem, moxifloxacin, ciprofloxacin and amikacin. The resistance rate of ciprofloxacin to levofloxacin was higher than that to vancomycin and sulfamethoxazole / methoxylamidine, the age was 60 years old, the mechanical ventilation time was 5 days, and the Apache II score of tracheotomy was 鈮，

本文編號(hào)：1824132