摘要
目的探讨老年脑卒中合并肺部感染患者的病原菌分布和耐药性,以及预防重症脑卒中患者并发肺部感染的干预措施。方法我院82例老年卒中合并肺部感染患者(观察组),及同期未发生肺部感染的42例老年卒中患者(对照组),均行问卷调查、细菌培养及药敏试验,比较两组问卷调查结果,观察组病原菌分布及耐药性。结果观察组侵入性操作、意识障碍、慢性阻塞性肺病(COPD)病史、糖尿病发生率均高于对照组(P<0.05);观察组共分离出病原菌95株,其中革兰阳性菌18.95%,革兰阴性菌75.79%,真菌5.26%;金黄色葡萄球菌对万古霉素、替考拉宁的耐药性为0.00%;主要革兰阴性菌对头孢哌酮/舒巴坦、美罗培南、阿米卡星、亚胺培南的耐药性均较低。结论侵入性操作、意识障碍、COPD病史、血糖高将增加肺部感染发生概率,而革兰阴性菌为肺部感染的主要致病菌,且其对抗菌药物均存在一定的耐药性,故应根据药敏试验结果合理使用抗菌药物。
Objective To investigate the distribution and drug resistance of pathogens in elderly stroke patients complicated with pulmonary infection and explore the intervention measures to prevent the pulmonary infection in patients with severe stroke.Methods Eighty-two senile stroke patients with pulmonary infection who were treated in our hospital were selected as observation group.In the same period,42 senile stroke patients without pulmonary infection were selected as the control group.The two groups were investigated with questionnaires,bacterial culture and susceptibility testing.The questionnaire survey results,pathogenic bacteria distribution and drug resistance were compared between the two groups.Results The incidence of invasive operation,disturbance of consciousness,history of chronic obstructive pulmonary disease（ COPD） and high blood sugar in the observation group were significantly higher than those in the control group（ P〈0. 05）.A total of 95 strains of pathogens were isolated from the observation group,among which,grampositive bacteria accounted for 18. 95%,gram-negative bacteria accounted for 75. 79% and fungi accounted for 5. 26%.The resistance of Staphylococcus aureus to vancomycin and teicoplanin was zero.The main gram-negative bacteria had low resistance to cefoperazone/sulbactam,meropenem,amikacin and imipenem.Conclusion Invasive operation,disturbance of consciousness,history of COPD and high blood sugar will increase the incidence of pulmonary infection.Gram-negative bacteria are the main pathogenic bacteria of the pulmonary infection,and have some resistance to antimicrobial drugs.Therefore,antibiotics should be used reasonably based on the results of susceptibility testing to ensure clinical efficacy.
作者
杨兰
李春明
李莎
YANG Lan;LI Chun-ming;LI Sha(Department of Internal Medicine,Jiangyou 903 Hospital,Mianyang 621700,China)
出处
《实用医院临床杂志》
2018年第4期190-193,共4页
Practical Journal of Clinical Medicine
关键词
脑卒中
肺部感染
病原菌
耐药性
预防策略
Stroke
Pulmonary infection
Pathogen
Drug resistance
Prevention strategy
