脑梗死患者肺部感染病原菌分布与耐药性分析

Analysis of pathogen distribution and drug resistance in cerebral infraction patients with pulmonary infections

目的探讨脑梗死患者肺部感染的病原菌分布并分析其耐药性,为临床合理应用抗菌药物提供有效数据。方法对2010年10月-2012年9月入住医院神经内科的2 017例脑梗死患者进行回顾性分析,数据采用SPSS13.0进行分析。结果发生肺部感染的患者有145例,发生率为7.2%;病原菌分布以革兰阴性菌为主,共98株占67.6%,革兰阳性菌36株占24.8%,真菌11株占7.6%;肺炎克雷伯菌和大肠埃希菌对氨苄西林100.0%耐药,金黄色葡萄球菌对青霉素100.0%耐药。结论医院脑梗死患者合并肺部感染的病原菌以革兰阴性菌为主,呈现多药耐药性,临床应加强病原菌耐药监测,合理使用抗菌药物,提高医院抗感染的质量,从而有效减少医院感染的发生,提高患者的预后。

OBJECTIVE To investigate the distribution of the pathogens and their drug resistance in cerebral infarction patients with pulmonary infections in our hospital,in order to provide efficient evidence for reasonable use of antibiotics in clinic.METHODS Totally 2017 cases of cerebral infarction patients in the neurology department in our hospital from Oct.2010 to Sep.2012 were analyzed retrospectively.RESULTS There were 145 cases of pulmonary infection patients,the incidence rate was 7.2%.The main pathogens were gram-negative bacteria（98strains,67.6%）.The number of gram-positive bacteria were 36 strains,accounting for 24.8%,and the number of fungi were 11 strains,accounting for 7.6%.The major pathogenic bacteria had a variety degrees of resistance to many antibiotic agents,the drug resistance rates of Klebsiella pneumoniae and Escherichia coli to ampicillin were 100.0%,and the drug resistance rate of Staphylococcus aureus to penicillin was 100.0%.CONCLUSION Pathogens in patients with cerebral infarction complicated with pulmonary infections were mainly gram-negative bacteria multiple drug resistance according to the drug sensitive test,clinicians should arouse sufficient attention,strengthen the monitoring of drug resistance of pathogens for rational use of antimicrobial drugs,improve the hospital antiinfective quality,so as to effectively reduce the incidence of hospital infections and improve patient prognosis.