老年阿尔茨海默病患者肺部感染的病原菌分布及危险因素分析

发布时间：2018-04-22 14:24

  本文选题：阿尔茨海默病 + 肺部感染　； 参考：《中华医院感染学杂志》2017年10期

【摘要】：目的分析阿尔茨海默病患者中阿尔茨海默病合并肺部感染的病原菌分布、耐药性及相关危险因素,为临床老年阿尔茨海默病患者的预后提供参考依据。方法选取2010年7月-2016年2月医院收治的老年阿尔茨海默病合并肺部感染痰培养阳性患者66例,对患者进行细菌培养及药敏试验,分析感染患者的病原菌分布、耐药性及相关感染影响因素。结果 66例痰培养阳性患者共分离病原菌106株,其中革兰阴性菌82株,占77.36%,以肺炎克雷伯菌、大肠埃希菌、铜绿假单胞菌为主,分别占38.68%、11.32%、11.32%,革兰阳性菌18株,占16.98%,以金黄色葡萄球菌、沃式葡萄球菌为主,分别占6.60%和4.72%,真菌6株,占5.66%;革兰阴性菌对亚胺培南、美罗培南的耐药率均9.00%,革兰阳性菌对万古霉素耐药率为0;单因素及多因素分析结果显示,年龄70岁、伴有糖尿病、长时间卧床、住院时间1个月、较长的病程时间及伴有吸烟史均是引发阿尔茨海默病合并肺部感染的危险因素。结论老年阿尔茨海默病合并肺部感染患者除了肺部功能降低外,还可导致慢性脑部缺氧性疾病,脑皮质血管受损,大脑对呼吸的调控能力下降,也是细菌不易从肺部清除的重要原因;对于老年阿尔茨海默病合并肺部感染者的病原菌分布、耐药性及感染危险因素的分析,对患者的预后具有重要的临床意义。
[Abstract]:Objective to analyze the distribution of pathogens, drug resistance and related risk factors of Alzheimer's disease complicated with pulmonary infection in order to provide reference for the prognosis of elderly patients with Alzheimer's disease. Methods 66 elderly patients with Alzheimer's disease complicated with pulmonary infection were selected from July 2010 to February 2016. Bacterial culture and drug sensitivity test were performed to analyze the distribution of pathogenic bacteria in the infected patients. Drug resistance and related infection factors. Results A total of 106 strains of pathogenic bacteria were isolated from 66 sputum culture positive patients, of which 82 were Gram-negative bacteria (77.36). Klebsiella pneumoniae, Escherichia coli and Pseudomonas aeruginosa were the main pathogens, accounting for 38.68% 11.322.32 and 18 Gram-positive bacteria, respectively. Accounting for 16.98%, mainly Staphylococcus aureus and Staphylococcus Vauciformis, accounting for 6.60% and 4.72%, respectively, 6 strains of fungi, accounting for 5.66%, Gram-negative bacteria to imipenem, The resistance rate of meropenem to vancomycin was 0.The results of univariate and multivariate analysis showed that the age was 70 years old, accompanied by diabetes mellitus, staying in bed for a long time, and staying in hospital for one month, the results showed that the drug resistance rate of meropenem was 9.00%, and the resistance rate of Gram-positive bacteria to vancomycin was 0. Long duration of disease and history of smoking are risk factors for Alzheimer's disease complicated with pulmonary infection. Conclusion in elderly patients with Alzheimer's disease complicated with pulmonary infection, chronic cerebral hypoxic diseases, cerebral cortical vessels damage and brain regulation of respiration can be caused in addition to the decrease of pulmonary function. It is also an important reason that bacteria is not easy to be removed from the lungs, and it is of great clinical significance to analyze the distribution of pathogens, drug resistance and risk factors of infection in elderly patients with Alzheimer's disease complicated with pulmonary infection.
【作者单位】： 宁波市康宁医院老年科;
【基金】：浙江省医药卫生科技计划基金资助项目(2016KYB308)
【分类号】：R563.1;R749.16
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本文编号：1787631