目的：探讨佛山市部分地区重症监护病房（ICU）呼吸机相关性肺炎的病原学分布及其耐药情况，以指导临床合理用药。方法选取2012-2014年佛山市部分地区ICU呼吸机相关性肺炎患者182例，使用支气管镜防污染毛刷对呼吸机相关性肺炎可疑患者采样并进行病原菌培养，采用K-B纸片法对药敏进行分析。结果3年中182例患者经纤维支气管镜防污染保护性毛刷采样，分离得到菌株163株，革兰氏阴性菌、革兰氏阳性菌以及真菌分别占69.9%、22.7%和7.4%，3年间病原学分布变迁不明显。3年间鲍曼不动杆菌耐药率明显升高。结论佛山市部分地区2012-2014年呼吸机相关性肺炎病原学变迁不明显，但是耐药率呈现逐年升高的趋势，临床上应根据常见病原菌的耐药性对患者进行经验性治疗。%Objective To explore the etiological distribution and drug resistance analysis of ventilator-associ-ated pneumonia in intensive care unit (ICU) in parts of Foshan, in order to guide rational use of drugs. Methods A total of 182 patients of ventilator-associated pneumonia in ICU in parts of Foshan from 2012 to 2014 were enrolled in the study. Samples were collected from the patients using bronchoscopic brush, and pathogen culture was conducted for fur-ther analysis. Drug resistance analysis was performed using KB method. Results A toal of 163 strains were isolated from the patients, with Gram-negative bacteria accounting for 69.9%, Gram-positive bacteria for 22.7%and fungi for 7.4%. In the three years, the changes in the distribution of pathogens were no significant. The resistant rate of Acineto-bacter baumannii was significantly increased. Conclusion From 2012 to 2014, patients with ventilator-associated pneu-monia showed no significant change in etiological distribution in parts of Foshan, but the drug resistance rates increased year by year. Patients should be treated empirically based on drug resistance analysis in clinical practice.
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