發(fā)布時間：2018-03-07 07:36

  本文選題：腦卒中相關性肺炎　切入點：多藥耐藥菌　出處：《中華醫(yī)院感染學雜志》2017年19期 　論文類型：期刊論文

【摘要】：目的探討導致多藥耐藥菌感染卒中相關性肺炎發(fā)生的危險因素并進行藥敏分析。方法選取醫(yī)院2014年9月-2016年8月腦卒中相關性肺炎住院患者148例,對患者進行痰培養(yǎng)和藥敏實驗,分析多藥耐藥菌感染的危險因素和耐藥菌分布及耐藥情況。結(jié)果對患者的一般資料與多藥耐藥菌感染的相關性進行分析可見,吸煙、飲酒、肺炎類型及意識狀態(tài)與多藥耐藥菌的感染之間的相關性具有統(tǒng)計學意義(P0.05),吸煙、飲酒、晚發(fā)型肺炎及昏迷均為導致患者術后感染的獨立危險因素(P0.05)。對73例多藥耐藥菌感染的患者進行病原學分析共分離得到多藥耐藥菌83株,其中革蘭陰性菌49株占59.04%,革蘭陽性菌34株占40.96%,其中有10例患者合并兩種以上的多藥耐藥菌感染。藥敏試驗結(jié)果顯示,多藥耐藥菌對臨床上所使用的大部分常用的抗菌藥物都具有較強的耐藥性,僅少數(shù)抗菌藥物能取得較好的抗菌效果。結(jié)論臨床上多藥耐藥菌感染的卒中相關性肺炎具有較高的發(fā)生率,且治療較為困難。臨床上應針對相關危險因素進行針對性的預防。對于已發(fā)生感染的患者,應及時使用一線抗菌藥物進行治療。
[Abstract]:Objective to investigate the risk factors and drug sensitivity analysis of stroke associated pneumonia caused by multidrug resistance bacteria. Methods 148 patients with stroke associated pneumonia from September 2014 to August 2016 in hospital were selected. Sputum culture and drug sensitivity test were carried out to analyze the risk factors of multidrug resistant bacteria infection, the distribution of drug resistant bacteria and the drug resistance. Results the correlation between the general data of patients and multidrug resistant bacteria infection was analyzed. The correlation between the type of pneumonia, the state of consciousness and the infection of multidrug resistant bacteria was statistically significant (P 0.05). Late type pneumonia and coma were the independent risk factors for postoperative infection. 83 strains of multidrug resistant bacteria were isolated from 73 patients with multidrug resistant bacteria infection. Among them, 49 strains were Gram-negative bacteria (49 strains) and 34 strains were Gram-positive bacteria (40.96%). Among them, 10 cases were complicated with more than two kinds of multidrug resistant bacteria infection. Multidrug resistant bacteria have strong resistance to most of the commonly used antimicrobial agents in clinical use. Only a few antimicrobial agents can obtain better antibacterial effect. Conclusion the incidence of stroke associated pneumonia caused by multidrug resistance bacteria infection is higher than that of other antimicrobial agents. It is difficult to treat. The clinical prevention should be aimed at the related risk factors, and the patients who have already been infected should be treated with first-line antibiotics in time.
【作者單位】： 寧波市奉化區(qū)人民醫(yī)院全科醫(yī)療科;安徽省太和縣人民醫(yī)院神經(jīng)內(nèi)科;寧波市奉化區(qū)人民醫(yī)院神經(jīng)內(nèi)科;
【分類號】：R563.1;R743.3

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