Clinical Analysis Of Ventilator-associated Pneumonia In Intensive Care Unit

Objective: Study of ventilator-associated pneumonia in intensive care unit (VAP)distribution and drug resistance of pathogenic bacteria, risk factors, and providescientific basis for prevention and treatment of ventilator-associated pneumonia.Methods:(1) The use of disposable sterile sputum suction tube through artificial airwaysecretion of lower respiratory tract specimens from bacterial culture as culture,according to the American Committee for clinical laboratory standards (NCCLS)guidelines, using two-fold agar dilution method, cultured for2times, the same strainwas identified as the pathogen. All French biology Meeri company VlTEK automaticanalyzer for microbial identification of bacteria using strain.(2) A review of67patientsfrom March to2011in October of2010in the intensive care unit with endotrachealintubation, tracheotomy and mechanical ventilation on>48h complicated withventilator-associated pneumonia were lower respiratory tract secretions for bacterialculture and antimicrobial susceptibility.(3) Statistical methods were statisticallyanalyzed using the SPSS11.5software, the continuous variables using independent ttest, were compared between groups using x2test, P<0.05had significant difference.The results of drug sensitivity by professional statisticians will be unified data entry inExcel form, and a check is made, using statistics software for data analysis, data wereexpressed as a percentage.Results: Isolated pathogens163,126gram-negative bacilli, accounting for77.3percent, including Acinetobacter baumannii on top of the list, accounting for34.0%, Pseudomonas aeruginosa in second place, accounting for17.2%, followed by KlebsiellapneumoniaeBo, Escherichia coli, respectively, accounted for10.4%,10.0%;26isolatedGram-positive cocci, accounting for16.0%, mainly Staphylococcus aureus (11.7%),Staphylococcus epidermidis (4.3%); fungal infectionsmore common, isolated11accounted for6.7%, mainly Candida albicans, accounting for4.3%, followed byCandida tropicalis offerings yeast and C. glabrata accounted for1.8%and0.6%,respectively. Most gram-negative bacilli to antimicrobial drugs showed higherresistance, but better role of beta-lactam antibiotics and imipenem against Gram-negative bacilli, Gram-positive cocci were sensitive to vancomycin.Conclusion:(1) For the prevention of VAP, should develop a comprehensiveprevention measures, including shorter duration of mechanical ventilation, mechanicalventilation in patients with long-term needs2weeks to give the tracheostomy,continuous subglottic attract, oral hygiene, the management of the tracheal tube,continuous soundHa attract semi-recumbent position, the inhibition of gastric acidsecretion, strict disinfection and sterilization of equipment operation and medical staffshould be in strict compliance with aseptic technique.(2) VAP treatment as soon aspossible selection of good lung penetration, strong broad-spectrum antibiotics, early,adequate and individualized medicine, and to enhance the nutritional support ofcritically ill patients, and actively to maintain the balance within the environment, andthe rational use of sugar corticosteroids, maintenance of the body’s immune defenses.Note that in the treatment of lower respiratory tract pathogen detection, rational use ofantibiotics based on bacterial culture and sensitivity test results correctly.