重症监护病房脑卒中相关性肺炎多重耐药菌感染的危险因素及病原学分析

发布时间：2018-01-06 01:25

本文关键词：重症监护病房脑卒中相关性肺炎多重耐药菌感染的危险因素及病原学分析　出处：《实用医学杂志》2016年13期 　论文类型：期刊论文

【摘要】：目的:探讨重症监护病房(ICU)脑卒中相关性肺炎(SAP)患者发生多重耐药(MDR)菌感染的危险因素及病原菌的分布,为临床防治提供依据。方法:回顾性分析ICU 2012年1月至2015年12月所有SAP患者的资料,χ~2检验比较各种因素SAP发生MDR菌感染差异,再选P0.05的因素进行多因素回归分析,分析MDR感染的危险因素和病原学分布。结果:352例脑卒中患者,发生SAP 183例,分离出病原菌247株,其中MDR菌193株(78.1%),MDR前5位为:鲍曼不动杆菌、铜绿假单胞菌、肺炎克雷伯杆菌、金黄色葡萄球菌、大肠埃希杆菌;MDR感染与住ICU时间大于7 d、严重意识障碍、晚发性肺炎和呼吸机通气时间大于7 d 4个因素有密切相关,差异有统计学意义(P0.05);结论:MDR发生率较高,住ICU时间大于7d、严重意识障碍、晚发性肺炎和呼吸机通气时间大于7 d是重症监护病房SAP发生MDR感染的高危因素。
[Abstract]:Objective: to investigate the risk factors and distribution of multidrug resistant MDR (MDR) infection in patients with stroke associated pneumonia (SAP) in intensive care unit (ICU). Methods: the data of all SAP patients with ICU from January 2012 to December 2015 were analyzed retrospectively. 蠂 ~ 2 test was used to compare the differences of MDR infection in various factors of SAP, and the factors of P05 were analyzed by multivariate regression analysis. The risk factors and etiological distribution of MDR infection were analyzed. Results among 352 stroke patients, 183 cases had SAP, and 247 strains of pathogenic bacteria were isolated. Among them, the top 5 MDR strains were Acinetobacter baumannii, Pseudomonas aeruginosa, Klebsiella pneumoniae, Staphylococcus aureus and Escherichia coli. The infection of MDR was closely related to the duration of ICU stay longer than 7 days, severe disturbance of consciousness, late pneumonia and ventilator ventilation longer than 7 days, and the difference was statistically significant (P 0.05). Conclusion the incidence of ICU is high, the duration of living in ICU is longer than 7 days, and there is serious disturbance of consciousness. Late pneumonia and ventilator-ventilated time more than 7 days were the risk factors of MDR infection in SAP in intensive care unit.
【作者单位】：广州医科大学附属第二医院重症医学科;
【分类号】：R743.3;R563.1
【正文快照】： 卒中相关性肺炎(stroke-associated pneumonia,SAP)是脑卒中患者最常见的并发症和主要死因[1]。重症监护病房(ICU)广谱抗生素的应用日益广泛,多重耐药(multi-drug resistance,MDR)菌检出率也随之升高,SAP感染难以控制,研究[2]表明,重症监护病房,SAP感染病原菌的分布、耐药情况

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