急性脑梗死患者肺部感染的病原学分析

Pathogenic analysis of pulmonary infection in acute cerebral infarction patients

目的探讨急性脑梗死患者肺部感染的病原学情况,并采取相对应的措施进行诊治,以期提高临床治疗质量。方法回顾性分析2010年1月-2013年1月133例急性脑梗死肺部感染患者的临床资料,对患者进行病原菌检测,分析其病原菌分布及耐药性;采用PPMS软件进行统计分析,计量资料采用t检验,计数资料采用χ2检验。结果共分离病原菌149株,其中革兰阳性菌68株占45.6%,革兰阴性菌61株占41.0%,真菌20株占13.4%;主要革兰阳性菌对万古霉素、亚胺培南、阿莫西林/克拉维酸、哌拉西林/他唑巴坦的耐药性较低,为0~31.2%,主要革兰阴性菌对美罗培南、亚胺培南、头孢曲松、氨苄西林/舒巴坦的耐药性较低,为0~15.8%。结论急性脑梗死患者肺部感染的病原菌较为复杂,临床上要加强监测,选择敏感的抗菌药物进行治疗。

OBJECTIVE To investigate the profile of pulmonary infections among the ACI patients and to take corresponding measures for diagnosis and treatment so as to improve the quality of clinical treatment.METHODS The clinical data of 133ACI patients who suffered pulmonary infections from Jan 2010to Jan 2013were retrospectively analyzed;pathogens from the patients were detected and the pathogen distribution and drug resistance were analyzed.PPMS software was adopted for statistical analysis,t test was adopted for measurement data and Chi-square test was adopted for enumeration data.RESULTS A total of 149strains of pathogens were isolated,with gram positive bacteria accounting for 45.6%（68strains）,gram negative bacteria accounting for 41.0%（61strains）and fungi accounting for 13.4%（20strains）;the dominant gram positive bacteria had low drug resistance to vancomycin,imipenem,amoxicillin/clavulanic acid,piperacillin/tazobactam from 0to 31.2%and the dominant gram negative bacteria had low drug resistance to meropenem,imipenem,ceftriaxone,and ampicillin/sulbactam from 0to 15.8%.CONCLUSION Pathogens causing pulmonary infections after suffering ACI are very complicated,which should be seriously monitored in clinical practice;besides,it is necessary to choose sensitive antibacterial agents for treatment.