不同ICU卒中相关性肺炎的病原学探讨

Distribution of pathogens isolated from stroke-associated pneumonia in different ICU

目的:探讨不同重症监护病房(ICU)的卒中相关性肺炎(SAP)患者的病原学分布。方法:2010-03-2012-03,对我院急诊ICU、老年ICU和综合ICU的卒中患者痰标本培养及药敏结果,进行回顾性分析。结果:142例SAP患者,124例痰液培养病原菌170株。革兰阴性菌103株(60.6%);真菌42株(24.7%);革兰阳性菌25株(14.7%)。急诊ICU细菌81株(47.6%),其中鲍曼不动杆菌20株(24.7%),MASA 18株(22.2%),大肠埃希菌10株(12.3%),肺炎克雷伯杆菌8株(9.9%);老年ICU细菌28株(16.5%),其中白假丝酵母菌10株(35.7%),光滑假丝酵母菌6株(21.4%),克柔假丝酵母菌4株(14.3%);综合ICU细菌61株(35.9%)。3组比较,老年ICU的真菌分离率最高,差异有统计学意义(P<0.05)。结论:不同ICU病房SAPP分布的病原菌菌株不同,应根据病原学特点,加强抗菌药物合理应用。

Objective：To analyze the pathogen distribution and resistance patterns of the positive clinical speci mens isolated from Stroke-associated Pneumonia in different ICU. Method： From March, 2010 to March, 2012, pa tients of brain stroke have been admitted to the different ICU,and a retrospective analysis involving their sputum cultivation and drug sensitivity is performed. Result：Of all the patients, 142 cases of SAP were found, among which 124 cases were positive for sputum cultivation. Altogether 170 strains of bacteria were isolated, of which 103 strains were Gram negative bacilli（60.6 % ）, 42 strains were fungi（24.7 % ）, 10 stains were Gram？ ？ positive cocci （14.1%）. There were 81 strains in EICU（47. 6%）, including 20 strains Acinetobacter baumannii（24. 7%）, 18 strains MASA（22. 2G）, 10 strains Escherichia coli （12. 3%）,8 strains Klebsiella pneumoniae （9. 9%）. There were 28 strains in Senium ICU（16.5 % ）, including 10 strains Candida albicans（35.7 % ）, 6 strains Candida glabrata （21.4%） ,4 strains Monilia krusei （14.3%）. There were 61 strains in integrated ICU（35.9%）. Fungi was com mon in Senium ICU, P〈0.05. Conclusion：The distribution of pathogens isolated from Stroke-associated Pneumonia varied with different ICU. MOnitoring the pathogen distribution will certainly benefit the outcome of SAP.