呼吸机相关性下呼吸道感染的微生物学诊断研究进展

摘要

呼吸机相关性下呼吸道感染（ VARI）是指机械通气48 h以后发生的下呼吸道感染，表现为呼吸机相关性气管支气管炎（ VAT）和呼吸机相关性肺炎（ VAP）。 VAT 和 VAP 临床上往往难以区分，VARI则提示感染，并考虑应用抗生素治疗。通过流行病学和发病机制、临床诊断、微生物学诊断以及治疗策略等的研究，可明确目前关于VAT、VAP、定植的诊断标准，强调具体的临床和微生物线索的重要性以区分感染和定植，并促进早期恰当的抗生素治疗。%Ventilator-assosiated respiratory infection ( VARI) refers to infection of the lower respiratory tract occurring after 48 hours of mechanical ventilation ,which may be manifested as ventilator-associated tra-cheobronchitis(VAT) and ventilator-associated pneumonia(VAP).The differentiation between VAT and VAP is often difficult in clinical .VARI is a term that indicates infection that deserves consideration for anti-biotic therapy.Here is to summarize the epidemiology and pathogens ,clinical diagnosis,microbiological diag-nosis,and management strategies for VARI,with the purpose to clarify current diagnostic criteria of VAT and VAP versus tracheal colonization and to underscore specific clinical and microbiologic clues that could lead to earlier,appropriate antibiotic treatment of VARI.