Pathogenic analysis of sputum from ventilator-associated pneumonia in a pediatric intensive care unit.
Pathogenic analysis of sputum from ventilator-associated pneumonia in a pediatric intensive care unit.
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儿科重症监护病房呼吸机相关性肺炎痰液病原学分析
DOI：
10.3892/etm.2012.757
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发表时间：
2013-01
影响因子：
2.7
通讯作者：
Chen ZJ
中科院分区：
文献类型：
--
作者：
Ning BT;Zhang CM;Liu T;Ye S;Yang ZH;Chen ZJ
呼吸机相关性肺炎（VAP）是儿科重症监护病房（PICU）常见且有时致命的并发症。目的了解我院PICU呼吸机相关性肺炎（VAP）患者痰标本分离的病原菌分布及药敏情况，为临床早期合理使用抗生素提供依据。本研究于2007年1月至2011年12月在浙江大学医学院附属儿童医院PICU进行。收集气管内吸出物，并在15 min内运送到微生物实验室。病原体进行常规分析，并用Vitek 60和Kirby-Bauer纸片扩散法进行鉴定。121例VAP患者痰标本中分离出127株病原菌。革兰阴性菌占64.57%（82/127），革兰阳性菌占29.92%（38/127），真菌占5.51%（7/127）。革兰阴性菌中鲍曼不动杆菌（25.61%）、大肠埃希菌（20.27%）、嗜麦芽窄食单胞菌（20.27%）、肺炎克雷伯菌（16.22%）和铜绿假单胞菌（9.46%）为常见分离菌。葡萄球菌对万古霉素和利奈唑胺敏感。所有真菌均对抗菌药物敏感。VAP中革兰阴性菌的检出率高于革兰阳性菌和真菌，且耐药率较高。对VAP患儿早期合理应用抗菌药物具有重要意义。了解VAP的耐药性及耐药特点对预防和治疗VAP具有重要意义。
Ventilator-associated pneumonia (VAP) is a common and sometimes fatal complication in pediatric intensive care units (PICU). The aim of our study was to characterize the distribution and drug susceptibility of the pathogens isolated from the sputum of patients with VAP in the PICU of our hospital and to provide support to the administration of antibiotics early and reasonably in the clinic. Our study was conducted between January 2007 and December 2011 at the PICU of the Children’s Hospital of Zhejiang University School of Medicine. The endotracheal aspirates were collected and transported to a microbiology laboratory within 15 min. The pathogens were routinely analyzed and identified with Vitek 60 and Kirby-Bauer disk diffusion methods. Among the 121 VAP patients, 127 pathogenic strains were isolated from sputum specimens. Gram-negative and gram-positive bacteria and fungi accounted for 64.57% (82/127), 29.92% (38/127) and 5.51% (7/127), respectively. Acinetobacter baumannii (25.61%), Escherichia coli (20.27%), Stenotrophomonas maltophilia (20.27%), Klebsiella pneumoniae (16.22%) and Pseudomonas aeruginosa (9.46%) were frequently identified isolates among gram-negative bacteria. Staphylococci were susceptible to vancomycin and linezolid. All fungi were sensitive to the antimicrobial agents. The gram-negative bacteria were more prevalent than gram-positive bacteria and fungi in VAP and demonstrated a higher drug resistance. It is important to administer antimicrobial agents early and reasonably for children with VAP. Knowledge of antibiotic resistance and the characteristics of drug resistance is important for VAP prophylaxis and treatment.
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DOI：
10.1164/ajrccm.153.1.8542110
发表时间：
1996-01-01
影响因子：
24.7
作者：
Cunnion, KM;Weber, DJ;Rutala, WA
通讯作者：
Rutala, WA
影响因子：
4.1
作者：
Morrow, Brenda M.;Mowzer, Rukaiya;Argent, Andrew C.
通讯作者：
Argent, Andrew C.
DOI：
10.12659/msm.881750
发表时间：
2011-05
期刊：
Medical science monitor : international medical journal of experimental and clinical research
影响因子：
--
作者：
Ak O;Batirel A;Ozer S;Çolakoğlu S
通讯作者：
Çolakoğlu S
影响因子：
11.8
作者：
Gales, AC;Jones, RN;Verhoef, J
通讯作者：
Verhoef, J
影响因子：
1.8
作者：
Gomez-Garces, J. L.;Aracil, B.;Burillo, A.
通讯作者：
Burillo, A.