脑出血肺部感染患者的病原菌分布与治疗效果研究

发布时间：2018-06-10 02:27

本文选题：脑出血 + 肺部感染　；参考：《中华医院感染学杂志》2016年02期

【摘要】：目的探究脑出血患者肺部感染的病原菌分布与治疗效果,为临床治疗提供参考依据。方法回顾性分析2013年1月-2015年1月医院收治的100例脑出血肺部感染患者临床资料,对患者的病原菌分布、药敏试验和治疗后1、3、5、7、10d的生存率进行分析。结果 100例患者共分离出176株病原菌,其中革兰阴性菌86株占48.9%,以大肠埃希菌、肺炎克雷伯菌和铜绿假单胞菌为主,革兰阳性菌24株占13.6%,以金黄色葡萄球菌和表皮葡萄球菌为主,真菌66株占37.5%,以白色假丝酵母菌为主;大肠埃希菌对妥布霉素和阿莫西林的耐药率均为100.0%;肺炎克雷伯菌对阿莫西林和替卡西林的耐药率均为100.0%;铜绿假单胞菌对磺胺甲VA唑/甲氧苄啶的耐药率最高为87.5%;金黄色葡萄球菌、表皮葡萄球菌和溶血葡萄球菌对青霉素的耐药率均为100.0%,治疗7d后有65例患者预后良好。结论脑出血后肺部感染的主要病原菌为革兰阴性菌,且对多种抗菌药物均有较高的耐药性,应加强对病原菌耐药性的监测,根据药敏结果合理用药,提高脑出血后肺部感染患者的生存率。
[Abstract]:Objective to investigate the pathogenic bacteria distribution and therapeutic effect of pulmonary infection in patients with intracerebral hemorrhage (ICH), and to provide reference for clinical treatment. Methods the clinical data of 100 patients with pulmonary infection of intracerebral hemorrhage admitted in our hospital from January 2013 to January 2015 were retrospectively analyzed. The distribution of pathogenic bacteria, drug sensitivity test and the survival rate of 10 days after treatment were analyzed. Results 176 strains of pathogenic bacteria were isolated from 100 patients, of which 86 were Gram-negative bacteria, mainly Escherichia coli, Klebsiella pneumoniae and Pseudomonas aeruginosa. 24 strains of Gram-positive bacteria were mainly Staphylococcus aureus and Staphylococcus epidermidis, 66 strains of fungi were 37.5%, and most of them were Candida albicans. The resistance rates of Escherichia coli to tobramycin and amoxicillin were both 100.0, Klebsiella pneumoniae to amoxicillin and ticacillin were both 100.0 and Pseudomonas aeruginosa to sulfamethazol / trimethoprim were the highest. Staphylococcus aureus, The resistance rates of Staphylococcus epidermidis and Staphylococcus haemolyticus to penicillin were both 100.00.There were 65 patients with good prognosis after 7 days of treatment. Conclusion the main pathogenic bacteria of pulmonary infection after intracerebral hemorrhage are Gram-negative bacteria and have high drug resistance to many kinds of antimicrobial agents. It is necessary to strengthen the monitoring of the drug resistance of the pathogens and use them reasonably according to the results of drug sensitivity. To improve the survival rate of patients with pulmonary infection after intracerebral hemorrhage.
【作者单位】：浙江省苍南县人民医院神经内科;浙江省苍南县人民医院检验科;
【基金】：浙江省科技厅基金资助项目(ZJWJKJ2014208)
【分类号】：R446.5

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