脑血管病合并肺部感染患者病原菌分布及耐药性分析

发布时间：2018-05-19 19:05

本文选题：肺部感染 + 脑血管病　；参考：《中国临床药理学杂志》2017年16期

【摘要】：目的分析脑血管病合并肺部感染患者的病原学分布和耐药性。方法选取125例脑血管病合并肺部感染患者的痰标本进行培养,对其病原菌分布和细菌耐药的情况进行统计分析。结果在125例患者的356次痰标本中,共培养出591株病原菌,排名前5位的细菌分别为铜绿假单胞菌、鲍曼不动杆菌、肺炎克雷伯杆菌、大肠埃希菌、奇异变形杆菌;产超广谱β内酰胺酶(ESBL)肺炎克雷伯杆菌12株,产ESBL大肠埃希菌19株;革兰氏阳性菌56例(占9.48%),革兰氏阴性菌424例(占71.74%)。铜绿假单胞菌对亚胺培南的耐药率达57.96%,对头孢他啶、环丙沙星、庆大霉素的耐药率均在30%左右;鲍曼不动杆菌对环丙沙星、头孢他啶、哌拉西林/他唑巴坦、亚胺培南、庆大霉素的耐药率均在70%以上;肺炎克雷伯菌对环丙沙星、左氧氟沙星、头孢他啶、氨曲南的耐药率均在30%左右,对头孢吡肟、亚胺培南、哌拉西林/他唑巴坦敏感;大肠埃希菌对环丙沙星、头孢他啶、庆大霉素的耐药率均在50%以上。结论老年脑血管病患者发生肺部感染的机率高,感染的病原菌多为多重耐药菌。
[Abstract]:Objective to analyze the pathogenic distribution and drug resistance of patients with cerebrovascular disease complicated with pulmonary infection. Methods 125 sputum samples from patients with cerebrovascular disease complicated with pulmonary infection were cultured and the distribution of pathogenic bacteria and drug resistance of bacteria were analyzed statistically. Results A total of 591 strains of pathogenic bacteria were cultured in 356 sputum samples from 125 patients. The top 5 bacteria were Pseudomonas aeruginosa, Acinetobacter baumannii, Klebsiella pneumoniae, Escherichia coli and Proteus mirabilis. There were 12 strains of Klebsiella pneumoniae producing extended-spectrum 尾 -lactamases, 19 strains of Escherichia coli producing ESBL, 56 cases of Gram-positive bacteria (9.48%), 424 cases of Gram-negative bacteria (71.74%). The resistance rate of Pseudomonas aeruginosa to imipenem was 57.96%, to ceftazidime, ciprofloxacin and gentamicin was about 30%, Acinetobacter baumannii was resistant to ciprofloxacin, ceftazidime, piperacillin / tazobactam, imipenem. The drug resistance rates of Klebsiella pneumoniae to ciprofloxacin, levofloxacin, ceftazidime and aztreonam were all about 30%, sensitive to cefepime, imipenem, piperacillin / tazobactam. The resistance rate of Escherichia coli to ciprofloxacin, ceftazidime and gentamicin was over 50%. Conclusion the incidence of pulmonary infection in elderly patients with cerebrovascular disease is high, and the most of pathogenic bacteria are multidrug resistant bacteria.
【作者单位】：中国人民解放军第305医院呼吸科;中国人民解放军第305医院药局;
【分类号】：R563.1;R743

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