某院2021年—2023年脑卒中合并肺部感染患者病原菌分布特点及耐药分析

Distribution Characteristics and Drug Resistance Analysis of Pathogens in Patients with Stroke Complicated with Pulmonary Infection in a Tertiary Hospital in Beijing from 2021 to 2023

目的分析北京市某三甲医院神经重症监护病房脑卒中患者合并肺部感染病原菌分布和耐药情况,为危重症患者的抗感染治疗提供数据支持。方法采用回顾性分析方法,从北京某三级甲等医院病案系统调取2021年1月1日-2023年12月31日神经重症监护住院患者信息,并调取患者住院期间检验科痰液标本结果及临床药敏试验结果进行分析。结果共分离出病原菌643株,以革兰氏阴性杆菌为主,其中肺炎克雷伯菌居首位;革兰氏阳性球菌以金黄色葡萄球菌为主。药敏结果显示万古霉素、利奈唑胺和替考拉宁对革兰氏阳性球菌具有高抗菌活性;革兰氏阴性杆菌中非发酵菌耐药情况稍重。结论及时掌握神经重症监护病房肺部感染患者的病原菌的种类和耐药性变化,对临床工作中抗菌药物的应用具有重要的指导意义。

Objectives This study aims to analyze the distribution and drug resistance of pathogens associated with pulmonary infection in stroke patients admitted to the neurological intensive care unit(NICU)of a tertiary hospital in Beijing,and to provide data support for anti-infection treatment of critically ill patients.Methods A retrospective analysis method was used to retrieve the information of patients hospitalized in neurocritical care from January 1,2021 to December 31,2023 from the medical record system of a tertiary-level A hospital in Beijing.The sputum specimens collected from the laboratory during the patients'hospitalization and the results of clinical drug sensitivity tests were retrieved for analysis.Results A total of 643 strains of pathogenic bacteria were isolated,mainly Gram-negative bacteria,with Klebsiella pneumoniae ranking first.Gram positive cocci were mainly Staphylococcus aureus.The drug sensitivity results showed that vancomycin,linezolid,and teicoplanin had high antibacterial activity against Gram positive cocci.The resistance of non-fermenting bacteria in Gram negative bacteria was slightly more severe.Conclusions Timely understanding of the types and drug resistance changes of pathogens in patients with pulmonary infections in the neurological intensive care unit has important guiding significance for the application of antibiotics in clinical work.