老年脑卒中相关性肺炎患者多药耐药菌感染病原学及相关因素探讨

发布时间：2018-03-04 10:32

本文选题：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07期 　论文类型：期刊论文

【摘要】：目的分析脑卒中相关肺炎(SAP)中老年患者中出现多药耐药菌者的临床特征、病原菌感染特点和耐药性特点,为临床防治SAP多药耐药菌感染提供参考依据。方法选取2013-2015年60岁以上接受诊治的脑卒中SAP患者269例为观察对象,对所有患者痰液样本进行病原菌和耐药性检测,分析多药耐药菌感染SAP的病原学和药敏学特点,并分析其感染危险因素。结果 SAP并发多药耐药菌感染率为55.76%;logistic回归分析显示侵入性操作、意识水平、神经功能缺损程度、SAP类型、预防性应用抗菌药物为SAP多耐药菌感染的独立危险因素(P0.01);SAP多药耐药菌感染病原菌主要为革兰阴性菌;革兰阴性菌敏感性最佳的药物为加替沙星,敏感率为100.00%。结论多种因素均能够增加老年SAP患者容易出现多药耐药菌感染的风险。
[Abstract]:Objective to analyze the clinical characteristics of multidrug resistant bacteria (MDR) in the elderly patients with stroke associated pneumonia (SAP), and to analyze the characteristics of pathogenic bacteria infection and drug resistance. Methods 269 stroke SAP patients aged over 60 years from 2013 to 2015 were selected as the observation objects. The sputum samples of all patients were tested for pathogens and drug resistance. The etiology and drug sensitivity of multidrug resistant bacteria infected with SAP were analyzed, and the risk factors of infection were analyzed. Results the infection rate of SAP complicated with multidrug resistance bacteria was 55.76%. Logistic regression analysis showed that the invasive operation, consciousness level and degree of nerve function defect were different from the type of SAP. Prophylactic use of antimicrobial agents was an independent risk factor for the infection of SAP multidrug resistant bacteria (P0.01), and the main pathogens were Gram-negative bacteria, and gatifloxacin was the most sensitive drug for Gram-negative bacteria. Conclusion multiple factors can increase the risk of multidrug resistant bacteria infection in elderly patients with SAP.
【作者单位】：安阳市人民医院神经内科;
【基金】：安阳市重大科技计划基金资助项目(20100012)
【分类号】：R563.1;R743.3

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