急性缺血性脑卒中继发MDROs感染性肺炎的病原学及相关因素分析

Analysis of etiology and related factors of MDROs infectious pneumonia secondary to acute cerebral ischemic stroke

目的:探究急性缺血性脑卒中(CIS)继发多重耐药菌(MDROs)感染性肺炎的病原学及相关因素。方法:回顾性分析某院就诊的231例CIS患者临床资料,将出现MDROs感染性肺炎的20例患者纳入观察组,将其余患者纳入对照组。分析观察组患者病原学特点及MDROs感染性肺炎相关因素。结果:观察组共检出病原菌32株,革兰氏阴性菌以铜绿假单胞菌为主,占比18.75%;革兰氏阳性菌以金黄色葡萄球菌为主,占比25%。Logistic回归分析显示,住院时间较长、卧床较久、低蛋白血症、使用3种以上抗菌药物均为CIS患者出现MDROs感染性肺炎的独立危险因素(P<0.05)。结论:引起CIS患者继发MDROs感染性肺炎的病原菌种类、危险因素较多,临床需在制定对应治疗措施的重点保护易感群体,减少此类情况发生。

Objective:To explore the etiology and related factors of multidrug-resistant organisms(MDROs)infectious pneumonia secondary to acute cerebral ischemic stroke(CIS).Methods:The clinical data of 231 patients with CIS treated in the hospital between March 2019 and October 2020 were retrospectively analyzed.20 patients with MDROs infectious pneumonia were included in observation group,and the remaining patients were included in control group.The etiological characteristics and related factors of MDROs infectious pneumonia were analyzed in observation group of patients.Results:A total of 32 strains of pathogenic bacteria were detected in observation group.Gram-negative bacteria were mainly Pseudomonas aeruginosa,accounting for 18.75%,and Gram-positive bacteria were mainly Staphylococcus aureus,accounting for 25%.Logistic regression analysis showed that long hospital stay,long bed rest,hypoproteinemia,and the use of more than 3 antibacterial drugs were independent risk factors for MDROs infectious pneumonia in patients with CIS(P<0.05).Conclusion:There are many pathogenic bacteria and risk factors that cause secondary MDROs infectious pneumonia in patients with CIS.Clinically,it is necessary to focus on the protection of vulnerable groups in the formulation of corresponding treatment measures to reduce the occurrence of such situation.