脑卒中患者下呼吸道感染病原菌的分布及耐药状况

Distribution and resistance analysis of pathogenic bacteria in patients with stroke in lower respiratory tract infection

目的探讨脑卒中并发下呼吸道感染的病原菌分布及耐药状况,以指导临床合理选用抗生素。方法回顾性调查分析146例脑卒中并发下呼吸道感染患者痰培养及药敏结果。结果 146例脑卒中并发下呼吸道感染者,痰培养共检出菌株157株,以革兰阴性杆菌为主(67.5%),其次为革兰阳性球菌(17.8%)和真菌(14.6%)。革兰阴性杆菌以肺炎克雷伯菌最多,其次为铜绿假单胞菌;革兰阳性球菌主要是葡萄球菌;真菌以白色假丝酵母菌为主。药敏试验显示,革兰阴性杆菌对亚胺培南、美罗培南最敏感;革兰阳性球菌对万古霉素最为敏感;真菌对5-氟胞嘧啶和两性霉素B较敏感。结论革兰阴性杆菌是脑卒中并发下呼吸道感染的主要病原菌,且细菌耐药性严重,真菌感染率较高,应当引起足够重视。

Objective To investigate the distribution and drug resistance of pathogenic bacteria in patients with stroke in lower respiratory tract infection to select drugs for clinical treatment rationally. MethodsThe bacterial culture of 146 lower respiratory tract samples of patients with stroke was positive and the results of bacteria identifi-cation and drug sensitivity tests were analyzed.ResultsOf 146 samples, 157 pathogens were isolated, Gram-negative bacteria was the dominant pathogens （67.5%）, the others in turn were Gram-positive cocci （17.8%） and fungi （14.7%）. Of Gram-negative bacteria, the most common pathogen was Klebsiella pneumoniae, and the other one was Pseudomonas aeruginosa. Staphylococci were the frequent cocci Of all Gram-positive cocci, and Candida albicans was the dominant fungi. The results of drug susceptibility showed the sensitivity of Gram-negative bacteria to mipenem and meropenem was the best, the sensitivity of Gram-positive cocci to vancomycin was the best, and the sensi-tivity of fungi to 5-Fluorocytosine and amphotericin B was better. ConclusionGram-negative bacteria are the dominant pathogens in lower respiratory tract infection from patients with stroke,the antibiotic resistance is serious, and the infection rate of fungi is high. It＇s necessary to pay sufficient attention to this status.