目的 探讨呼吸重症监护病房(RICU)和重症监护病房(ICU)呼吸机相关肺炎的病原学分布及耐药情况,指导临床合理使用抗菌药物.方法 回顾分析我院2007-2009年经纤维支气管镜防污染保护性毛刷获取的呼吸机相关肺炎的病原体分布以及药敏试验结果.结果 分离出菌株326株中革兰阴性菌228株(69.9%),以铜绿假单胞菌和鲍曼不动杆菌为主;革兰阳性菌74株(22.7%),以金黄色葡萄球菌为主;真菌24株(7.4%).其中耐药率升高最明显的是鲍曼不动杆菌.结论 经支气管镜防污染毛刷取样诊断呼吸机相关肺炎具有准确可靠的优点,现阶段细菌耐药率明显升高,加强耐药性监测,合理使用抗菌药物非常重要.%Objective To investigate the change pattern of antimicrobial resistance and pathogenic distribution of ventilator associated pneumonia ( VAP ) in RICU and ICU.Methods VAP pathogenic distribution obtained from protected — specimen brush in RICU and ICU and its antimicrobial susceptibility test results were analyzed retrospectively from 2007 to 2009.Results A total of 326 strains were separated, including 228 strains of Gram — negative bacteria ( 69.9％ , mainly pseudomonas aeruginosa and acinetobacter baumannii ), 74 Gram - positive ( 22.7％ , mainly staphylococcus aureus ), 24 fungi ( 7.4％ ).The rise of resistance rate of acinetobacter baumannii was the most notable.Conclusion Bronchofibroscope protected - specimen brush is accurate and reliable in diagnosis of VAP.Drug resistance is rising significantly now, so it is important to strengthen the monitoring of drug resistance and to use rationally antimicrobial agents.[
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