脑梗死患者医院感染病原菌分布与耐药性分析

The analysis of pathogen distribution and drug resistance of hospital infections in patients with cerebral infarction

目的观察脑梗死患者医院感染的病原菌分布及耐药性,探讨预防医院感染的相关措施,为临床合理用药提供依据。方法回顾性分析2012年1月-2014年1月412例脑梗死患者医院感染率、感染部位分布、病原菌种类及药敏试验结果。结果 412例脑梗死患者发生医院感染49例,感染率为11.9%;感染部位以下呼吸道感染为主占40.8%;共分离培养出病原菌56株,其中革兰阳性菌31株占55.4%、革兰阴性菌23株占41.0%、真菌2株占3.6%;金黄色葡萄球菌对青霉素、头孢克洛、克林霉素的耐药率较高,>80.0%;对环丙沙星、万古霉素和替考拉宁较为敏感,耐药率<20.0%。结论脑梗死患者医院感染以下呼吸道感染为主,金黄色葡萄球菌是感染的最主要病原菌,耐药现象严重,临床应根据相关危险因素积极采取预防对策,降低脑梗死患者医院感染的发生。

OBJECTIVE To analyze the pathogen distribution and drug resistance of hospital infection in patients with cerebral infarction ,and discuss preventive measures for hospital infections ,so as to provide the basis for rational drug use .METHODS Totally 412 cases of patients with cerebral infarction from Jan .2012 to Jan .2014 were analyzed retrospectively for hospital infection rate , infection site distribution , pathogen types , and susceptibility results .RESULTS Hospital infections occurred in 49 patients with the infection rate of 11 .9% .The lower respiratory tract was the main infection site ,accounting for 40 .8% .The 56 detected strains of pathogens included 31 strains of gram‐positive bacteria accounting for 55 .4% ,23 strains of gram‐negative bacteria accounting for 41 .0% ,2 strains of fungi accounting for 3 .6% .Staphylococcus aureus showed high resistance to penicillin , cefaclor ,and clindamycin with the resistance rate above 80 .0% and showed sensitivity to ciprofloxacin ,vancomy‐cin and teicoplanin with the resistance rate below 20 .0% .CONCLUSION Hospital infection in cerebral infarction patients mainly occurs in lower respiratory tract and pathogens are mainly S . aureus and have serious drug resistance .Clinicians should develop effective preventive measures based on related risk factors to reduce the occurrence of hospital infections in cerebral infarction patients .