帕金森病患者肺部感染病原菌分布与耐药性分析

发布时间：2018-02-01 03:36

  本文关键词： 帕金森病 肺部感染 临床漏诊　出处：《中华医院感染学杂志》2017年10期 　论文类型：期刊论文

【摘要】：目的探讨帕金森病患者肺部感染临床漏诊原因,总结病原菌分布和耐药情况,以期降低漏诊和感染率。方法回顾性分析2011年1月-2013年1月86例帕金森病肺部感染患者,统计其病原菌分布和耐药性,并对其中漏诊的11例患者的漏诊原因进行总结。结果帕金森病肺部感染86例患者中共培养出病原菌107株,其中革兰阴性菌72株,占67.29%,革兰阳性菌35株,占32.71%;革兰阴性菌中铜绿假单胞菌占28.97%、大肠埃希菌占17.76%、阴沟肠杆菌占12.15%;革兰阳性菌中金黄色葡萄球菌占15.89%、肺炎链球菌占10.28%;革兰阴性菌对亚胺培南、美罗培南耐药率均为0,对其余抗菌药物的耐药率均52.63%;革兰阳性菌对万古霉素耐药率为0,对其余抗菌药物的耐药率均72.73%;在帕金森病肺部感染漏诊原因中以口服药物影响最常见,占36.37%,其他的主要是停药、用药不足或减药引起,占27.27%,误吸占18.18%,医师忽视占18.18%。结论帕金森病患者肺部感染病原菌较多,漏诊率高,原因多为主观性。
[Abstract]:Objective to investigate the causes of clinical missed diagnosis of pulmonary infection in patients with Parkinson's disease (PD) and to summarize the distribution of pathogenic bacteria and drug resistance. Methods from January 2011 to January 2013, 86 patients with pulmonary infection of Parkinson's disease were analyzed retrospectively. The causes of missed diagnosis in 11 patients with Parkinson's disease were summarized. Results A total of 107 strains of pathogenic bacteria were cultured in 86 patients with pulmonary infection of Parkinson's disease, of which 72 strains were Gram-negative bacteria (67.29% strains). 35 Gram-positive bacteria (32.71%); Pseudomonas aeruginosa accounted for 28.97, Escherichia coli 17.76 and Enterobacter cloacae 12.15. Among Gram-positive bacteria, Staphylococcus aureus accounted for 15.89%, Streptococcus pneumoniae 10.28%. The resistance rates of Gram-negative bacteria to imipenem and meropenem were 0 and 52.63 to other antimicrobial agents. The resistance rate of gram-positive bacteria to vancomycin was 0, and that to other antimicrobial agents was 72.73. Oral drugs are the most common cause of missed diagnosis of pulmonary infection in Parkinson's disease (36.37%). The rest are mainly caused by withdrawal of drugs, insufficient use or reduction of drugs, accounting for 27.27%, and 18.18%% by mistake. Conclusion Pulmonary infection in patients with Parkinson's disease has more pathogenic bacteria and high rate of missed diagnosis, which is mainly caused by subjectivity.
【作者单位】： 海南省中医院神经内科;
【基金】：海南省中医药管理局基金资助项目(hn28123)
【分类号】：R563.1;R742.5
【正文快照】： 帕金森病是一种进程缓慢的神经系统变性疾病,晚期则由于肌强直和全身僵硬等卧床不起,加上该疾病好发于老年人,基础疾病多,营养状态差,免疫力差。帕金森病患者最大的问题是患者生活质量严重下降,生活不能自理,由于神经的退化,活动能力、思维能力受限,导致患者多种脏器功能受限,，

本文编号：1480825