脑血栓患者医院感染性肺炎病原菌分布与药敏分析

Analysis of pathogen distribution and drug resistance of nosocomial pneumoniain patients with cerebral thrombosis

目的探讨脑血栓患者发生医院感染性肺炎的病原菌分布,并对病原菌的耐药性进行分析,为临床脑血栓患者发生医院感染性肺炎的预防和诊治提供依据。方法选择2011年3月-2013年3月因脑血栓就诊并发生医院感染性肺炎患者120例,统计感染性肺炎病原菌种类及季节分布,并通过药敏试验对病原菌的药敏性进行研究。结果脑血栓患者医院感染性肺炎主要病原菌种类与季节无明显相关性;主要病原菌分布为革兰阳性菌143株占45.3%、革兰阴性菌164株占51.9%、真菌9株占2.8%;革兰阴性菌中肺炎克雷伯菌、大肠埃希菌以及铜绿假单胞菌检出率分别占20.9%、18.4%、8.5%;金黄色葡萄球菌对万古霉素敏感率为100.0%、肺炎克雷伯菌和大肠埃希菌对亚胺培南敏感率分别为100.0%、94.8%,铜绿假单胞菌对头孢他啶和亚胺培南敏感率分别为77.8%、88.9%。结论脑血栓患者发生医院感染性肺炎主要为混合性感染,其病原菌种类因季节不同无明显差异,多数菌具有较强耐药性,需要使用高级别抗菌药物进行治疗,因此临床应特别注重医院感染性肺炎的预防。

OBJECTIVE To investigate and analyze the pathogen distribution and drug resistance of nosocomial pneumonia in patients with cerebral thrombosis and provide a basis for the prevention and treatment to the patients.METHODS Totally 120 patients with cerebral thrombosis combined with nosocomial pneumonia were selected from Mar.2011 to Mar.2013 in our hospital.The pathogen types and seasonal distribution of nosocomial pneumonia were analyzed and drug resistance of pathogens was conducted by the drug ssusceptibility testing.RESULTS The main types of pathogens in thrombosis patients with nosocomial pneumonia had no relation with seasons;the distribution of main pathogens were 143 strains of gram-positive bacteria,164 strains of gramnegative bacteria and 9strains of fungus,accounting for 45.3%,51.9% and 2.8%,respectively.The detection rates of Klebsiella pneumoniae,Escherichia coli and Pseudomonas aeruginosa were 20.9%,18.4% and 8.5%,respectively.The susceptibility rate of Staphylococcus aureus to vancomycin was 100.0%,the susceptibility rates of K.pneumoniae and E.coli to imipenem were 100.0%and 94.8%,and the susceptibility rates of P.aeruginosato ceftazidime and imipenem were 77.8% and 88.9%.CONCLUSION The occurrence of nosocomial pneumonia in patients with thrombosis were mainly mixed infections,and the types of pathogens are not changed by seasons,and the majority of the bacteria have strong resistance to antibiotics thus need more advanced antibiotic drugs,therefore,special attention should be paid to the prevention of the nosocomial pneumonia clinically.