The risk factor and drug-resistance analysis of ventilator-associated pneumonia in NICU department

HE Yin; WANG Xing-yong

doi:10.13406/j.cnki.cyxb.2011.09.025

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The risk factor and drug-resistance analysis of ventilator-associated pneumonia in NICU department

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- The risk factor and drug-resistance analysis of ventilator-associated pneumonia in NICU department
- Journal of Chongqing Medical University Vol. 36, Issue 9, Pages: 1107-1110(2011)
- 作者机构：
  
  重庆医科大学附属儿童医院急诊科
- 作者简介：
- 基金信息：
- DOI：10.13406/j.cnki.cyxb.2011.09.025
  CLC： R722.1
- Published：2011，
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[1]贺引,王兴勇.新生儿呼吸机相关肺炎危险因素及耐药菌谱分析[J].重庆医科大学学报,2011,36(09):1107-1110.

HE Yin, WANG Xing-yong. The risk factor and drug-resistance analysis of ventilator-associated pneumonia in NICU department. [J]. Journal of Chongqing Medical University 36(9):1107-1110(2011)
[1]贺引,王兴勇.新生儿呼吸机相关肺炎危险因素及耐药菌谱分析[J].重庆医科大学学报,2011,36(09):1107-1110. DOI： 10.13406/j.cnki.cyxb.2011.09.025.

HE Yin, WANG Xing-yong. The risk factor and drug-resistance analysis of ventilator-associated pneumonia in NICU department. [J]. Journal of Chongqing Medical University 36(9):1107-1110(2011) DOI： 10.13406/j.cnki.cyxb.2011.09.025.

摘要

目的:探讨新生儿呼吸机相关性肺炎（Ventilator associated pneumonia

VAP）的危险因素、病原菌、耐药性及预防措施。方法:回顾分析2008年1月-2010年1月我院新生儿重症监护室（Neonatal intensive care unit

NICU）中使用呼吸机机械通气127例危重新生儿临床资料。其中43例发生VAP。利用统计分析VAP发生与患儿胎龄、出身体重、基础疾病关系。收集深部痰液样本分离病原菌并进行耐药分析。结果:胎龄（<28周）、低出生体重（<2 000 g）、感染性基础疾病为VAP发生的危险因素

不同时间VAP患儿的发生率及死亡率差别有统计学意义（P<0.005）。分离培养病原菌发现主要病原菌为革兰阴性杆菌

占80.3%

其中以肺炎克雷伯菌、大肠埃希菌、铜绿假单胞菌最多见

且多为耐药菌。结论:NICU中VAP发生与患儿胎龄、体重及基础疾病密切相关

其病原菌以革兰阴性杆菌为主

对美罗培南、亚胺培南最为敏感

治疗中应根据细菌培养结果正确合理选择抗生素

提高机械通气的效率。

Abstract

Objective:To investigate the morbidity

risk factor

etiology characteristics

and drug resistance spectrum of ventilatorassociated pneumonia(VAP) and provide reasonable ways for VAP prevention.Methods:A retrospective study was conducted in 127 neonatal intensive care unit(NICU) patients admitted to the Children’s Hospital of Chongqing Medical University from January 2008 to January 2010.43 patients developed VAP.Statistical analysis was carried out to investigate the correlation between VAP incidence and gestational age

birth weight and primary disease.The sputum samples were used for drug resistance analysis.Results:Statistical analysis showed that gestational age

low birth weight

and primary infection disease were risk factors associated with the development of VAP.The morbidity and mortality of VAP at different time points had statistically significant difference(P<0.005).The proportion of gram negative bacilli was the highest(80.3%).The most common gram-negative organisms were klebsiella pneumoniae

pseudomonas aeruginosa

escherichia coli and the drug resistance was high in NICU.Conclusion:VAP is related to gestational age

birth weight and primary disease.The most common causative bacteria of VAP are gram-negative organisms

which are highly sensitive to meropenem

imipenem.It is reasonable to choose antibiotic based on the bacterium identified so as to improve the efficiency of mechanical ventilation.

关键词

新生儿呼吸机相关肺炎危险因素耐药性

Keywords

neonateventilator associated pneumoniarisk factordrug resistance

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