急性脑梗死患者下呼吸道感染的病原菌分布与耐药性研究

发布时间：2018-06-08 11:58

本文选题：急性脑梗死 + 下呼吸道感染　；参考：《中华医院感染学杂志》2016年09期

【摘要】：目的探讨急性脑梗死患者下呼吸道感染病原菌分布及其耐药性,为临床治疗提供依据。方法选取2014年4月-2015年2月医院收治的72例急性脑梗死并发下呼吸道感染患者,统计分析患者感染病原菌类型及其耐药性;使用法国生物梅里埃公司VITEK-2Compact 30全自动微生物分析系统进行菌株鉴定,采用E-test法进行药敏试验,采用Whonet5.4软件进行药敏统计分析。结果 72例临床急性脑梗死发生下呼吸道感染患者送检标本分离出病原菌68株,检出率94.44%,其中革兰阴性菌31株占45.59%,以肺炎克雷伯菌、铜绿假单胞菌和大肠埃希菌为主,革兰阳性菌29株占42.65%,以金黄色葡萄球菌和肺炎链球菌为主,真菌8株占11.76%,以白色假丝酵母菌、光滑假丝酵母菌为主;肺炎克雷伯菌、铜绿假单胞菌和大肠埃希菌对青霉素、氨苄西林、阿莫西林和庆大霉素耐药率均40.00%,对亚胺培南、美罗培南耐药率均10.00%;金黄色葡萄球菌和肺炎链球菌对万古霉素、亚胺培南耐药率均为0,对红霉素、氨苄西林和庆大霉素的耐药率40.00%;白色假丝酵母菌和光滑假丝酵母菌对氟康唑、伊曲康唑和伏立康唑的耐药率20.00%,对两性霉素B的耐药率40.00%。结论急性脑梗死并发下呼吸道感染患者感染病原菌种类较多,感染病原菌以革兰阴性菌和革兰阳性菌为主,临床治疗中可根据药敏结果选择敏感的抗菌药物进行治疗。
[Abstract]:Objective to investigate the distribution and drug resistance of pathogens of lower respiratory tract infection in patients with acute cerebral infarction, and to provide evidence for clinical treatment. Methods from April 2014 to February 2015, 72 patients with acute cerebral infarction complicated with lower respiratory tract infection were selected. Strain identification was carried out by using VITEK-2Compact 30 automatic microbiological analysis system of French Biomerier Company, drug sensitivity test was carried out by E-test method, and drug sensitivity statistical analysis was carried out by Whonet 5.4 software. Results Sixty-eight strains of pathogenic bacteria were isolated from 72 clinical patients with acute cerebral infarction with lower respiratory tract infection. The detection rate was 94.44. Among them, 31 strains of Gram-negative bacteria accounted for 45.59. Klebsiella pneumoniae, Pseudomonas aeruginosa and Escherichia coli were the most common pathogens, and the main pathogens were Klebsiella pneumoniae, Pseudomonas aeruginosa and Escherichia coli. 29 strains of Gram-positive bacteria accounted for 42.65%, mainly Staphylococcus aureus and Streptococcus pneumoniae, 8 strains of fungi accounted for 11.76, mainly Candida albicans, Candida smooth Candida, Klebsiella pneumoniae, Pseudomonas aeruginosa and Escherichia coli for penicillin, The resistance rates of ampicillin, amoxicillin and gentamicin were 40.00m and 10.00 to imipenem and meropenem, respectively, and the resistance rates of Staphylococcus aureus and Streptococcus pneumoniae to vancomycin, imipenem and erythromycin were 0 and 10.00 respectively, and the resistance rates of Staphylococcus aureus and Streptococcus pneumoniae to vancomycin and imipenem were 0, respectively. The resistance rates of ampicillin and gentamicin were 40.00.The resistance rates of Candida albicans and Candida smooth to fluconazole itraconazole and voriconazole were 20.00 and 40.002 respectively. Conclusion there are many kinds of pathogenic bacteria in patients with acute cerebral infarction complicated with lower respiratory tract infection. Gram-negative bacteria and Gram-positive bacteria are the main pathogens of infection. Sensitive antimicrobial agents can be selected according to the results of drug sensitivity in clinical treatment.
【作者单位】：南阳市中心医院神经内科;南阳市中心医院感染办;
【基金】：河南省科技厅基金资助项目(132300410383)
【分类号】：R743.3

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