急性脑血管病患者并发难治性肺部感染的细菌病原学及药物敏感性分析

Bacterial etiology of complicated failed pulmonary infection and drug susceptibility in patients with acute cerebrovascular disease

目的:分析急性脑血管病并发难治性肺部感染的细菌病原学及药物敏感性,为临床使用抗生素提供依据。方法:2000-01/2004-01东南大学附属江阴人民医院神经内科收治50例急性脑血管病并发难治性肺部感染患者,对50例患者的病原学及其药物敏感性进行回顾性调查。结果:50例急性脑血管病并发难治性肺部感染患者,多为多重耐药菌感染,其中革兰阴性杆菌占50.9%,革兰阳性球菌占44.6%,真菌为4%。阴性杆菌以肺炎克雷伯氏杆菌占首位,耐青酶烯类抗生素亚胺培南/西司他丁的抗菌性最强,其次为含有内酰胺酶抑治剂的头孢哌酮/舒巴坦和环丙沙星;球菌以金黄色葡萄球菌为主,其中大部分是耐苯唑西林金黄色葡萄球菌,仅对万古霉素敏感。结论:依据细菌学及抗菌药物敏感性资料,选择经验性药物,控治感染,减少新的耐药菌出现。

AIM:To analyze the bacterial etiology of complicated failed pulmonary infection and drug susceptibility in patients with acute cerebrovascular disease,so as to offer the evidence for antibiotic applied clinically. METHODS:A retrospective survey on the bacterial etiology of complicated failed pulmonary infection and drug susceptibility in 50 patients with acute cerebrovascular disease was analyzed in the Department of Neurology,Affiliated Yinjiang People's Hospital,Southeast University,between January 2000 and January 2004. RESULTS:Most of the patients were infected by multi-resistance bacteria among 50 cerebrovascular disease patients with complicated failed pulmonary infection,including gram negative bacilli for 50.89%,gram positive cocci for 44.64%and fungi for 4%.Negative bacilli mainly included K.peneumoniae bacilli.The antibacterial effect was imipenem/cilastatin first and lactamasetest inhibitor of cefoperazone/sulbactam and ciprofloxacin secondly.Cocci mainly included staphylococcus aureaus,and most of it was tolerant oxacillin staphylococcus aureaus,which was susceptive to vancomycin only. CONCLUSION:According to the data of antiseptic drug susceptibility and bacteriology,empirical drug is selected,infection controlled,and tolerant medical bacteria reduced.