脑卒中相关性肺炎多药耐药菌感染危险因素与药敏分析

发布时间：2018-03-07 07:36

本文选题：脑卒中相关性肺炎　切入点：多药耐药菌　出处：《中华医院感染学杂志》2017年19期 　论文类型：期刊论文

【摘要】：目的探讨导致多药耐药菌感染卒中相关性肺炎发生的危险因素并进行药敏分析。方法选取医院2014年9月-2016年8月脑卒中相关性肺炎住院患者148例,对患者进行痰培养和药敏实验,分析多药耐药菌感染的危险因素和耐药菌分布及耐药情况。结果对患者的一般资料与多药耐药菌感染的相关性进行分析可见,吸烟、饮酒、肺炎类型及意识状态与多药耐药菌的感染之间的相关性具有统计学意义(P0.05),吸烟、饮酒、晚发型肺炎及昏迷均为导致患者术后感染的独立危险因素(P0.05)。对73例多药耐药菌感染的患者进行病原学分析共分离得到多药耐药菌83株,其中革兰阴性菌49株占59.04%,革兰阳性菌34株占40.96%,其中有10例患者合并两种以上的多药耐药菌感染。药敏试验结果显示,多药耐药菌对临床上所使用的大部分常用的抗菌药物都具有较强的耐药性,仅少数抗菌药物能取得较好的抗菌效果。结论临床上多药耐药菌感染的卒中相关性肺炎具有较高的发生率,且治疗较为困难。临床上应针对相关危险因素进行针对性的预防。对于已发生感染的患者,应及时使用一线抗菌药物进行治疗。
[Abstract]:Objective to investigate the risk factors and drug sensitivity analysis of stroke associated pneumonia caused by multidrug resistance bacteria. Methods 148 patients with stroke associated pneumonia from September 2014 to August 2016 in hospital were selected. Sputum culture and drug sensitivity test were carried out to analyze the risk factors of multidrug resistant bacteria infection, the distribution of drug resistant bacteria and the drug resistance. Results the correlation between the general data of patients and multidrug resistant bacteria infection was analyzed. The correlation between the type of pneumonia, the state of consciousness and the infection of multidrug resistant bacteria was statistically significant (P 0.05). Late type pneumonia and coma were the independent risk factors for postoperative infection. 83 strains of multidrug resistant bacteria were isolated from 73 patients with multidrug resistant bacteria infection. Among them, 49 strains were Gram-negative bacteria (49 strains) and 34 strains were Gram-positive bacteria (40.96%). Among them, 10 cases were complicated with more than two kinds of multidrug resistant bacteria infection. Multidrug resistant bacteria have strong resistance to most of the commonly used antimicrobial agents in clinical use. Only a few antimicrobial agents can obtain better antibacterial effect. Conclusion the incidence of stroke associated pneumonia caused by multidrug resistance bacteria infection is higher than that of other antimicrobial agents. It is difficult to treat. The clinical prevention should be aimed at the related risk factors, and the patients who have already been infected should be treated with first-line antibiotics in time.
【作者单位】：宁波市奉化区人民医院全科医疗科;安徽省太和县人民医院神经内科;宁波市奉化区人民医院神经内科;
【分类号】：R563.1;R743.3

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