The drug resistance and pathogenic analysis from deep sputum of ventilator-associated pneumonia in children
10.3760/cma.j.issn.1673-4912.2014.08.009
- VernacularTitle:PICU呼吸机相关性肺炎深部痰液病原菌分布与耐药性分析
- Author:
Xiaosa CHEN
;
Chenmei ZHANG
;
Botao NING
- Publication Type:Journal Article
- Keywords:
Ventilator-associated pneumonia;
Sputum;
Drug resistance;
Children
- From:
Chinese Pediatric Emergency Medicine
2014;21(8):504-507
- CountryChina
- Language:Chinese
-
Abstract:
Objective To characterize composition and antibiotic resistance of the pathogens isolated from patients' deep sputum with ventilator-associated pneumonia(VAP) in PICU of our hospital,and give support to the administration of antibiotics early and reasonably in clinic.Methods The study was conducted during the period of January 2009 to December 2013 at PICU of the Children's Hospital of Zhejiang University School of Medicine.One hundred and twenty-one cases of children who conformed to the diagnostic criteria of VAP after treated with ventilator were the object,the endotracheal aspirates were collected and transported to microbiology laboratory within 15 minutes.The pathogens were routinely analyzed and identified with WITEK60 and used Kirby-Bauer method for drug sensitive test,and identified with the special drug-resistant bacteria.Results Among 121 VAP diagnosed patients,127 pathogenic strains isolated from sputum specimen.Gram negative,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％,21/127),Escherichia coli (20.27％,17/127),Stenotrophomonas maltophilia (20.27 ％,17/127),Klebsiella pneumoniae (16.22％,12/127) and Pseudomonas aeruginosa (9.46％,11/127) were frequently identified isolates among Gram negative bacteria.The resistant rate of Gram negative bacteria in β lactam antibiotics was 77.62％.Ten strains of Staphylococcus epidermis and 6 strains of Staphylococcus aureus were identified isolates among Gram positive bacteria.Except the sensitive to vancomycin and linezolid,Gram positive bacteria were resistance to cephalosporin and aminoglycosides.All fungi were sensitive to the anti-microbial agents.Conclusion The Gram negative bacteria were more prevalent than Gram positive bacteria and fungi in VAP and show high drug resistance.It is pivotal to administer anti-microbial agents early and reasonably for VAP children.To emphasize surveillance to the antibiotic resistance and grasp the characteristics of the drug resistance are much important to VAP therapy.
