关键词: 结核, 肺/并发症, 肺炎, 呼吸机相关性, 革兰氏阴性菌, 真菌

Abstract: Objective  To analyze the clinical characteristics of pathogens spectrum of ventilator-associated pneumonia(VAP) occurring in patients with pulmonary tuberculosis in the intensive care unit (ICU) and to provide a clinical strategy of using antibacterial agents. Methods  Fifty-eight pulmonary tuberculosis patients with VAP from January 2007 to January 2011 were retrospectively analyzed in clinical features，bacterial culture of sputum and results of drug sensitiveness test.  Results  One hundred and four bacterial strains were isolated in the sputum from the 58 pulmonary tuberculosis patients with VAP, which gram-negative bacilli，gram-positive cocci，and fungi accounted for 68.3%（71/104）, 7.7%（8/104）and 24.0%（25/104）, respectively. The major pathogens were acinetobacter baumannii (26.0%, 27/104）, pseudomonas aeruginosa(21.2%, 22/104）and candida albicans(14.4%, 15/104）. Twenty-six cases(44.8%, 26/58) had co-infections with at least 2 kinds of pathogens. Conclusion  The main pathogens in VAP with pulmonary tuberculosis are gram-negative bacilli and fungi, mixed infection is high．

Key words: Tuberculosis, pulmonary/complications, Pneumonia, ventilator-associated, Gram-negative bacteria, Fungi