急性脑血管病老年患者医院感染病原菌分布与耐药性分析

Distribution and drug resistance of pathogens causing nosocomial infections in elderly patients with acute cerebrovascular disease

目的探讨分析急性脑血管病老年患者医院感染的病原菌分布及耐药性,为临床有效地控制住院患者医院感染及医师合理应用抗菌药物提供理论依据。方法对2013年神经外科收治的老年急性脑血管病发生医院感染的72例患者送检标本进行分离培养,并对分离出的病原菌进行菌株鉴定及药敏试验。结果 72例患者送检的各类标本中共培养分离169株病原菌,其中革兰阴性菌106株占62.72%、革兰阳性菌59株占34.91%、真菌4株占2.37%;金黄色葡萄球菌、表皮葡萄球菌对青霉素类抗菌药物耐药率高达96.8%、90.9%;大肠埃希菌、铜绿假单胞菌、鲍氏不动杆菌对头孢唑林等头孢菌素类耐药率分别为93.1%、100.0%、100.0%;肺炎克雷伯菌对氨苄西林耐药率达95.0%。结论老年急性脑血管病患者医院感染的主要病原菌以革兰阴性杆菌为主,且耐药性高。

OBJECTIVE To investigate the distribution and drug resistance of pathogens causing nosocomial infec-tions in elderly patients with cerebrovascular disease so as to provide theoretical bases for effective control of the nosocomial infections in the hospitalized patients and for the reasonable clinical use of antibiotics .METHODS A to-tal of 72 elderly acute cerebrovascular disease patients complicated with nosocomial infections who were treated in the neurosurgery department in 2013 were enrolled in the study ,then the submitted specimens that were obtained from the participants were cultured ,the isolated pathogens were identified ,and the drug susceptibility testing was performed .RESULTS Totally 169 strains of pathogens have been isolated from the submitted specimens obtained from the 72 patients ,including 106 （62 .72% ） strains of gram-negative bacteria ,59 （34 .91% ） strains of gram-positive bacteria ,and 4 （2 .37% ） strains of fungi .The drug resistance rates of S .aureus and Staphylococcus epi-dermidis to penicillins were 96 .8% and 90 .9% ,respectively ;the drug resistance rates of the E .coli ,P .aerugi-nosa ,and A .baumannii to cephalosporins such as cefazolin were 93 .1% ,100% ,and 100% ,respectively ;the drug resistance rate of K .pneumoniae to ampicillin was 95 .0% .CONCLUSION The gram-negative bacilli are domi-nant among the pathogens causing nosocomial infections in the elderly patients with acute cerebrovascular disease and are highly drug-resistant .