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| 我院呼吸机与儿童相关性肺炎的病原菌及耐药分析 |
| Analysis of the Pertinence of Bacteria and Antibiotic Resistance against Children''''s Ventilator-associated Pneumonia in our Hospital |
| 投稿时间：2006-11-03 |
| DOI： |
| 中文关键词: 呼吸机相关性肺炎 耐药病原菌 儿童 |
| 英文关键词:Ventilator-associated pneumonia,Antibiotic Resistance,Pediatrics |
| 基金项目:国家科技攻关项目 |
| 王刚 陈沅 匡风梧 刘恩梅 熊菀 刘作义 黄英 刘岚 沈叙庄 杨永弘 |
| 重庆医科大学附属儿童医院，重庆医科大学附属儿童医院，重庆医科大学附属儿童医院，重庆医科大学附属儿童医院，重庆医科大学附属儿童医院，重庆医科大学附属儿童医院，重庆医科大学附属儿童医院，重庆医科大学附属儿童医院，首都医科大学附属北京儿童医院，首都医科大学附属北京儿童医院 重庆400014，重庆400014，重庆400014，重庆400014，重庆400014，重庆400014，重庆400014，重庆400014 |
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| 中文摘要: |
| 目的:了解儿童呼吸机相关性肺炎的主要病原菌,为临床治疗和预防提供参考。方法:调查我院儿科重症监护病房2000年1月～2005年12月收治的35例呼吸机相关性肺炎患者的临床资料、致病菌及其药敏结果。结果:35例呼吸机相关性肺炎患者分离出病原菌53株,以G~-杆菌为主,占71.69%,依次为铜绿假单胞菌、不动杆菌、肺炎克雷白杆菌;G~ 球菌主要为金黄色葡萄球菌及MRSA;分离菌株对大多数抗生素呈高耐药水平。G~-杆菌仅仅对亚胺培南、阿米卡星、妥布霉素、环丙沙星、头孢他啶相对较敏感;未发现G~ 球菌包括MRSA耐万古霉素菌株,其余相对敏感的抗生素依次为利福平、环丙沙星、氯霉素;行MV时间>7d是发生呼吸机相关性肺炎的高危因素,头孢类第三代抗生素与多种抗生素联合用药>7 d时易并发真菌感染。结论:依据呼吸机相关性肺炎的高危因素和致病菌及其耐药特性,临床采取相应的预防和治疗措施。 |
| 英文摘要: |
| Objective:To understand the main pathogenic bacteria of the children's ventilator-associated pneu- monia(YAP)and to provide references for clinic physician treatments and preventions for correlative diseases.Method: The clinical data of their pathogenic bacteria and medical result of antibiotic allergy were studied in 35 cases VAP hospital- ized in PICU Children' s Hospital of Chongqing University of Medical Sciences from January of 2000 to December 2005.Re- sult:53 strains of bacteria were separated in 35 cases VAP.The main cause of the disease was the gram negative bacteria occupying 71.69%,then pseudomonas,irreobacteria and Klebsiellar pneumoniae in order.The main gram-positive bacte- ria were staphylocccus aureus and MRSA;most of the separated bacteria presented their high antibiotic resistance.Gram negative bacteria were relativity sensitive to imipenem,amikacin,tobramycin,ciprofloxacin and ceftazidime.Gram-positive bacteria including MRSA were not found to be sensitive to vancomycin.The other relatively sensitive antibiotics were rifam- picin,ciprofloxacin and chloromycetin.The time of using the mechanical ventilation(MV)for more or fewer than 7days was the highly dangerous factors.The fungi infection arose in the easiest way when the various antibiotics were administered with the third generation cepbalosporins for more or fewer than 7 days.Conclusion:Physicians may adopt some correspond- ing preventive and treatment measures according to the YAP highly dangerous factor,pathogenic bacteria and antibiotic re- sistance characteristics. |
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