老年卒中相关性肺炎多药耐药菌感染的危险因素及病原学分析

Risk factors for multidrug-resistance bacteria infections in senile patients with stroke-associated pneumonia and analysis of etiology

目的研究医院老年卒中相关性肺炎患者多药耐药菌感染的危险因素及病原学分析,指导临床控制多药耐药菌引起的老年卒中相关性肺炎发生。方法选取2011年6月-2013年6月老年卒中相关性肺炎患者215例,分离培养病原菌并进行耐药性分析,研究老年卒中相关性肺炎患者多药耐药菌感染的危险因素。结果患者有卒中史、合并有其他疾病、吸烟史、饮酒史、意识状态、肺炎类型、所住病房不同、进行手术、应用导尿管以及未预防性应用抗菌药物均是老年卒中相关性肺炎发生多药耐药菌感染的危险因素;革兰阳性菌40株占32.79%,革兰阴性菌79株占68.75%。结论医院老年卒中相关性肺炎发生多药耐药菌感染的发生率较高,临床应采取措施控制医院老年卒中相关性肺炎发生多药耐药菌感染。

OBJECTIVE To explore the risk factors for the multidrug-resistant bacteria infections in the senile patients with stroke-associated pneumonia and analyze the etiology so as to provide guidance for the clinical control of the stroke-associated pneumonia caused by the multidrug-resistant bacteria. METHODS A total of 215 senile patients with stroke-associated pneumonia, who were treated in the hospital from Jun 2011 to Jun 2013, were enrolled in the study, then the pathogens were cultured and isolated, the drug resistance was analyzed, and the risk factors for the multidrug-resistant bacteria infections in the senile patients with stroke-associated pneumonia were observed. RESULTS The risk factors for the multidrug-resistant bacteria infections in the senile patients with stroke-associated pneumonia included the stroke history, complication of other diseases, smoking history, drinking history, state of consciousness, type of pneumonia, hospitalization ward, surgery, use of catheter, and without antibiotics prophylaxis. There were 40 （32. 79%） strains of gram-positive bacteria and 79 （68. 75%） strains of gram-negative bacteria. CONCLUSION The incidence of multidrug-resistant bacteria infections is high in the senile patients with stroke-associated pneumonia; it is necessary for the hospital to take effective control measures so as to reduce the incidence of multidrug-resistant bacteria infections in the senile patients with stroke-associated pneumonia.