本文選題：阿爾茨海默病 + 肺部感染��； 參考：《中華醫(yī)院感染學(xué)雜志》2017年10期

【摘要】：目的分析阿爾茨海默病患者中阿爾茨海默病合并肺部感染的病原菌分布、耐藥性及相關(guān)危險(xiǎn)因素,為臨床老年阿爾茨海默病患者的預(yù)后提供參考依據(jù)。方法選取2010年7月-2016年2月醫(yī)院收治的老年阿爾茨海默病合并肺部感染痰培養(yǎng)陽(yáng)性患者66例,對(duì)患者進(jìn)行細(xì)菌培養(yǎng)及藥敏試驗(yàn),分析感染患者的病原菌分布、耐藥性及相關(guān)感染影響因素。結(jié)果 66例痰培養(yǎng)陽(yáng)性患者共分離病原菌106株,其中革蘭陰性菌82株,占77.36%,以肺炎克雷伯菌、大腸埃希菌、銅綠假單胞菌為主,分別占38.68%、11.32%、11.32%,革蘭陽(yáng)性菌18株,占16.98%,以金黃色葡萄球菌、沃式葡萄球菌為主,分別占6.60%和4.72%,真菌6株,占5.66%;革蘭陰性菌對(duì)亞胺培南、美羅培南的耐藥率均9.00%,革蘭陽(yáng)性菌對(duì)萬(wàn)古霉素耐藥率為0;單因素及多因素分析結(jié)果顯示,年齡70歲、伴有糖尿病、長(zhǎng)時(shí)間臥床、住院時(shí)間1個(gè)月、較長(zhǎng)的病程時(shí)間及伴有吸煙史均是引發(fā)阿爾茨海默病合并肺部感染的危險(xiǎn)因素。結(jié)論老年阿爾茨海默病合并肺部感染患者除了肺部功能降低外,還可導(dǎo)致慢性腦部缺氧性疾病,腦皮質(zhì)血管受損,大腦對(duì)呼吸的調(diào)控能力下降,也是細(xì)菌不易從肺部清除的重要原因;對(duì)于老年阿爾茨海默病合并肺部感染者的病原菌分布、耐藥性及感染危險(xiǎn)因素的分析,對(duì)患者的預(yù)后具有重要的臨床意義。
[Abstract]:Objective to analyze the distribution of pathogens, drug resistance and related risk factors of Alzheimer's disease complicated with pulmonary infection in order to provide reference for the prognosis of elderly patients with Alzheimer's disease. Methods 66 elderly patients with Alzheimer's disease complicated with pulmonary infection were selected from July 2010 to February 2016. Bacterial culture and drug sensitivity test were performed to analyze the distribution of pathogenic bacteria in the infected patients. Drug resistance and related infection factors. Results A total of 106 strains of pathogenic bacteria were isolated from 66 sputum culture positive patients, of which 82 were Gram-negative bacteria (77.36). Klebsiella pneumoniae, Escherichia coli and Pseudomonas aeruginosa were the main pathogens, accounting for 38.68% 11.322.32 and 18 Gram-positive bacteria, respectively. Accounting for 16.98%, mainly Staphylococcus aureus and Staphylococcus Vauciformis, accounting for 6.60% and 4.72%, respectively, 6 strains of fungi, accounting for 5.66%, Gram-negative bacteria to imipenem, The resistance rate of meropenem to vancomycin was 0.The results of univariate and multivariate analysis showed that the age was 70 years old, accompanied by diabetes mellitus, staying in bed for a long time, and staying in hospital for one month, the results showed that the drug resistance rate of meropenem was 9.00%, and the resistance rate of Gram-positive bacteria to vancomycin was 0. Long duration of disease and history of smoking are risk factors for Alzheimer's disease complicated with pulmonary infection. Conclusion in elderly patients with Alzheimer's disease complicated with pulmonary infection, chronic cerebral hypoxic diseases, cerebral cortical vessels damage and brain regulation of respiration can be caused in addition to the decrease of pulmonary function. It is also an important reason that bacteria is not easy to be removed from the lungs, and it is of great clinical significance to analyze the distribution of pathogens, drug resistance and risk factors of infection in elderly patients with Alzheimer's disease complicated with pulmonary infection.
【作者單位】： 寧波市康寧醫(yī)院老年科;
【基金】：浙江省醫(yī)藥衛(wèi)生科技計(jì)劃基金資助項(xiàng)目(2016KYB308)
【分類號(hào)】：R563.1;R749.16
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本文編號(hào)：1787631