【摘要】：目的探討急性腦卒中患者肺部感染的病原菌特點及其對抗菌藥物的耐藥性,為臨床早期控制急性腦卒患者肺部感染提供參考依據(jù)。方法回顧性分析醫(yī)院2013年1月-2015年2月收治的254例急性腦卒中患者的臨床資料,分析患者肺部感染率、痰液培養(yǎng)后病原菌分布特點及耐藥性;采用SPSS17.0軟件對數(shù)據(jù)進行統(tǒng)計分析。結(jié)果 254例急性腦卒中患者發(fā)生肺部感染56例,發(fā)生率為22.05%;共分離出病原菌69株,其中革蘭陰性菌53例占76.81%,革蘭陽性菌13株占18.84%,真菌3株占4.35%;革蘭陰性菌中肺炎克雷伯菌對頭孢吡肟和環(huán)丙沙星的耐藥性較高,分別達76.47%和82.35%;鮑氏不動桿菌對環(huán)丙沙星和哌拉西林的耐藥性達61.54%和53.85%;銅綠假單胞菌對環(huán)丙沙星和哌拉西林的耐藥率為66.67%和55.56%;革蘭陽性菌中金黃色葡萄球菌對青霉素G、頭孢唑林、甲氧嘧啶及左氧氟沙星的耐藥率較高,80.00%;肺炎鏈球菌對青霉素G、頭孢唑林、克林霉素、甲氧嘧啶和左氧氟沙星的耐藥率50.00%。結(jié)論急性腦卒中患者肺部感染的病原菌主要以革蘭陰性菌為主,臨床醫(yī)師應(yīng)根據(jù)病原菌培養(yǎng)鑒定及藥敏試驗結(jié)果科學(xué)合理地應(yīng)用抗菌藥物。
[Abstract]:Objective to investigate the characteristics of pathogenic bacteria and antibiotic resistance of pulmonary infection in patients with acute stroke, and to provide reference for early clinical control of pulmonary infection in patients with acute stroke. Methods the clinical data of 254 patients with acute stroke from January 2013 to February 2015 were analyzed retrospectively. the pulmonary infection rate, the distribution characteristics and drug resistance of pathogenic bacteria after sputum culture were analyzed, and the data were statistically analyzed by SPSS17.0 software. Results Pulmonary infection occurred in 56 cases (22.05%) of 254 patients with acute stroke, 69 strains of pathogenic bacteria were isolated, including 53 cases of Gram-negative bacteria (76.81%), 13 strains of Gram-positive bacteria (18.84%) and 3 strains of fungi (4.35%). The resistance of Klebsiella pneumoniae to cefepxime and ciprofloxacin was 76.47% and 82.35%, respectively. The resistance of Acinetobacter baumannii to ciprofloxacin and piperacillin was 61.54% and 53.85%, the resistance rate of Pseudomonas aeruginosa to ciprofloxacin and piperacillin was 66.67% and 55.56%, and the resistance rate of Staphylococcus aureus to penicillin G, cefazolin, methoxypyrimidine and levofloxacin was 80.00%. The resistance rate of Streptococcus pneumoniae to penicillin G, cefazolin, clindamycin, methoxypyrimidine and levofloxacin was 50.00%. Conclusion Gram-negative bacteria are the main pathogens in pulmonary infection in patients with acute stroke. Clinicians should use antibiotics scientifically and reasonably according to the results of pathogen culture and drug sensitivity test.
【作者單位】： 南陽市中心醫(yī)院神經(jīng)康復(fù)科;
【基金】：河南省科技廳自然科學(xué)基金資助項目(1000700164)
【分類號】：R446.5

【參考文獻】

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1 陳玉s，

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