目的：探讨重症监护病房（ ICU）呼吸机相关肺炎（ ventilator-associated pneumo-nia，VAP）患者血流感染病原菌分布及耐药情况，为指导医院感染的预防控制和临床合理使用抗生素提供依据。方法使用全自动微生物分析系统（ VITEK2 COMPACT）对我院ICU 275例VAP患者的血液标本进行细菌鉴定和药敏试验，运用WHONET5.6软件对微生物检测结果进行统计分析。结果275例VAP患者中有194例发生血流感染，病原菌主要以革兰阴性菌为主，占50.52％；其次为革兰阳性菌（39.18％）和真菌（10.30％）。在革兰阴性杆菌中，大肠埃希菌和肺炎克雷伯菌仍旧是最主要的血流感染病原菌，对亚胺培南、美罗培南、阿米卡星均高度敏感；革兰阳性球菌以表皮葡萄球菌和金黄色葡萄球菌为主，对万古霉素、利奈唑胺及替考拉宁高度敏感。结论 ICU检出的病原菌多为条件致病菌和多重耐药菌，及时掌握ICU VAP患者血流感染的病原菌分布及其对抗菌药物的耐药情况，对合理应用抗菌药物具有重要指导意义。%Objective To analyze the distributions and drug resistance of pathogenic bacteria related to bloodstream infection in patients with ventilator-associated pneumonia ( VAP) at intensive care unit ( ICU) in order to provide the information for reasonable use of antibacterial agents and guide the control and prevention of hospital infection.Methods The pathogenic bacterial identification and drug sensitive test of bacteria were carried out by using an automatic microbial analysis system (VITEK2 COMPACT).WHO-NET5.6 software was used for statistical analysis.Results There were 194 cases with bloodstream infection in 275 patients.The main pathogens were gram negative bacteria,accounting for 50.52%,followed by gram positive bacteria (39.18%) and fungi (10.30%).In gram-negative bacilli,Klebsiella pneumoniae and Escherichia coli were still the main pathogens causing bloodstream infections and highly sensitive to imipenem,meropenem and amikacin.In gram-positive cocci mainly were Staphylococcus epidermidis and Staphylo-coccus aureus and highly sensitive to vancomycin,linezolid and teicoplanin.Conclusion Pathogenic bacteria and multiple drug resist-ant bacteria are detected by ICU.The distribution of pathogenic bacteria and drug resistance of VAP in ICU patients are mastered which is of great significance for rational use of antibiotics.
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