老年急性脑卒中肺部医院感染患者痰标本分离病原菌及耐药性

发布时间：2018-05-22 17:33

本文选题：老年 + 急性脑卒中　；参考：《中国感染控制杂志》2017年07期

【摘要】：目的了解老年急性脑卒中肺部医院感染患者痰标本分离病原菌及耐药情况,为临床抗菌药物合理应用提供依据。方法采用回顾性分析方法,对2011年3月—2013年9月某院干部病房年龄≥60岁的380例老年急性脑卒中患者进行医院感染的调查,对医院感染患者痰标本分离细菌进行鉴定和药敏检测。结果发生肺部医院感染54例,送检116份痰标本共分离病原菌80株,其中革兰阴性(G-)杆菌61株(76.25%),革兰阳性(G+)球菌7株(8.75%),真菌12株(15.00%),居前5位的病原菌依次是肺炎克雷伯菌、铜绿假单胞菌、鲍曼不动杆菌、白假丝酵母菌、大肠埃希菌。G-杆菌对美罗培南、亚胺培南、哌拉西林/他唑巴坦、阿米卡星等敏感率100%;G+球菌对万古霉素、利奈唑胺、替考拉宁敏感率100%;真菌对氟康唑、伊曲康唑等常用的抗真菌药敏感率100%。结论老年急性脑卒中肺部感染病原菌以G-杆菌为主,多重耐药菌株比例高,真菌感染呈上升趋势,临床上应加强病原菌监测,合理选用抗菌药物。
[Abstract]:Objective to investigate the isolation of pathogenic bacteria and drug resistance in sputum samples from elderly patients with acute stroke pulmonary nosocomial infection, and to provide evidence for rational use of antimicrobial agents. Methods A retrospective analysis was used to investigate the nosocomial infection in 380 elderly patients with acute stroke, aged more than 60 years, in a cadre ward of a hospital from March 2011 to September 2013. The bacteria isolated from sputum of nosocomial infection patients were identified and drug sensitivity was detected. Results A total of 80 strains of pathogenic bacteria were isolated from 116 sputum samples of 54 cases of pulmonary nosocomial infection, among which 61 strains of Gram-negative G-bacilli were found to be in the form of 76.25m, 7 strains of Gram-positive G) cocci were found to be part of the tube, and 12 strains of fungi were 15. 00%. The top 5 pathogens were Klebsiella pneumoniae. Pseudomonas aeruginosa, Acinetobacter baumannii, Candida albicans, Escherichia coli. G- Bacillus were sensitive to meropenem, imipenem, piperacillin / tazobactam, amikacin, etc. Teicoplanin sensitivity rate 100; Fungi to fluconazole, itraconazole and other commonly used antifungal drug sensitivity rate 100. Conclusion G- bacillus is the main pathogen of pulmonary infection in elderly patients with acute cerebral apoplexy. The proportion of multidrug resistant strains is high and the fungal infection is on the rise. It is necessary to strengthen the monitoring of pathogenic bacteria in clinic and select antibiotics reasonably.
【作者单位】：河北联合大学附属开滦总医院;
【分类号】：R563.1;R743.3

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