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目的 分析重症监护室 (ICU)病人建立人工气道后医院内肺炎 (NP)的危险因素及抗菌药物的合理应用。方法 回顾总结我院ICU2 0 0 0年 7月至 2 0 0 3年 12月NP的病原菌谱、耐药性及临床特征。结果 5 2例NP感染菌 14 9株中革兰阴性 (G-)杆菌占 6 7 11%、革兰阳性 (G+ )球菌占 15 4 4 %、真菌占 9 4 0 % ,L型菌占 8 0 5 % ;NP感染的病原菌以革兰阴性菌为主 ,G-杆菌以铜绿假单胞菌为主 (43 0 0 % ) ,G+ 球菌主要为金黄色葡萄球菌 (5 6 5 2 % ) ,几种主要致病菌对各种抗生素均有不同程度的耐药性。结论 必须加强ICU机械通气病人下呼吸道细菌的检测 ,采取多种防治措施 ,在治疗NP时应根据药敏结果合理使用抗生素。
Objective To analyze the risk factors of nosocomial pneumonia (NP) and the rational use of antimicrobial agents in patients with intensive care unit (ICU) after establishment of artificial airway. Methods The pathogenic bacteria spectrum, drug resistance and clinical features of NP in our hospital from July 2000 to December 2003 were reviewed. Results Gram-negative bacilli accounted for 67.11%, 14.4% for Gram-positive bacteria, 9.44% for fungi and 8% for L-type bacteria The main pathogens of NP infection were Gram-negative bacteria, Pseudomonas aeruginosa (4300%), G + bacteria (Staphylococcus aureus) (5652%), Several major pathogens have different degrees of resistance to various antibiotics. Conclusion The detection of lower respiratory tract bacteria in patients with mechanical ventilation of ICU should be strengthened. A variety of control measures should be taken. Antibiotics should be used rationally according to the susceptibility results when treating NP.