阿尔茨海默病患者医院感染的病原学分析及临床治疗

发布时间：2018-10-15 15:29

【摘要】：目的探讨阿尔茨海默病患者继发医院感染的病原学特点以及临床治疗方法,以降低阿尔茨海默病患者继发医院感染率。方法选取2011年4月-2013年5月收治阿尔茨海默病患者150例,根据临床表现对其是否发生医院感染进行初步判断,并行细菌培养及予药敏试验;采用WHONET5.4软件进行数据统计。结果 150例患者中发生医院感染21例,感染率为14.00%,其中以下呼吸道感染为主,占10.00%;132株病原菌中以革兰阴性菌为主占66.67%,其中大肠埃希菌最为常见占23.81%;革兰阳性菌占28.57%,其中以金黄色葡萄球菌占14.29%和肠球菌属占9.52%为主;真菌感染占4.76%;常见革兰阴性菌普遍对阿米卡星、亚胺培南敏感,除大肠埃希菌外均对左氧氟沙星敏感性较高,而肺炎克雷伯菌对抗菌药物普遍敏感;金黄色葡萄球菌和肠球菌属对氯霉素敏感性较高,其次是利福平,而对其他抗菌药物敏感性普遍偏低。结论阿尔茨海默病患者是发生医院感染的高危人群,应密切观察患者的临床表现,当有感染征象时早期通过细菌培养确定诊断,并及时给予经验性用药治疗,待药敏试验结果报告后,再对治疗用药进行调整。
[Abstract]:Objective to investigate the etiological characteristics and clinical treatment of secondary nosocomial infection in patients with Alzheimer's disease (AD), so as to reduce the secondary nosocomial infection rate. Methods 150 patients with Alzheimer's disease were selected from April 2011 to May 2013. According to their clinical manifestations, the hospital infection was preliminarily judged, bacteria culture and drug sensitivity test were performed, and the data were analyzed by WHONET5.4 software. Results Nosocomial infection occurred in 21 out of 150 patients, and the infection rate was 14.00. Among the 132 pathogenic bacteria, gram-negative bacteria accounted for 66.67, among which Escherichia coli accounted for 23.81%, Gram-positive bacteria 28.57%, Staphylococcus aureus 14.29% and Enterococcus 9.52%. The common gram-negative bacteria were generally sensitive to amikacin and imipenem, except Escherichia coli to levofloxacin, while Klebsiella pneumoniae was generally sensitive to antibiotics. Staphylococcus aureus and Enterococcus have a higher sensitivity to chloramphenicol followed by rifampicin while the sensitivity to other antimicrobial agents is generally low. Conclusion Alzheimer's disease is a high risk group with nosocomial infection. The clinical manifestations of the patients should be observed closely. The diagnosis should be confirmed by bacterial culture in the early stage, and empirical medication should be given in time. After the results of the drug sensitivity test were reported, the medication was adjusted.
【作者单位】：山东省医学科学院附属医院内科;山东省医学科学院附属医院院感科;
【基金】：国家自然科学基金资助项目(81273776)
【分类号】：R749.16

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