临床和实验医学杂志
臨床和實驗醫學雜誌
림상화실험의학잡지
JOURNAL OF CLINICAL AND EXPERIMENTAL MEDICINE
2014年
24期
2063-2065
,共3页
脑卒中相关性肺炎%病原菌%抗生素%耐药
腦卒中相關性肺炎%病原菌%抗生素%耐藥
뇌졸중상관성폐염%병원균%항생소%내약
Stroke-associated pneumonia%Pathogens%Antibiotics%Resistance
目的:探讨老年脑卒中相关性肺炎病原菌分布及对抗生素的耐药性。方法选择脑卒中相关性肺炎的老年患者231例,进行痰培养及药敏试验,并分析。结果135例患者检出病原体,总阳性率为58.44%,其中包括革兰阴性菌共86株(63.70%),革兰阳性菌共23株(17.03%),真菌26株(19.26%),其中混合感染占18.51%。革兰阴性菌中主要包括:肺炎克雷伯杆菌有27株(20.0%),鲍曼不动杆菌17株(12.60%),铜绿假单胞菌14株(10.37%)。革兰阳性菌中包括金黄色葡萄球菌13株(9.63%),肺炎链球菌7株(5.19%),凝固酶阳性葡萄球菌3株(2.22%)。真菌中白假丝酵母菌最为多见,有17株(12.0%)。对肺炎克雷伯杆菌敏感的抗生素有亚胺培南、头孢吡肟等;对鲍曼不动杆菌较敏感的抗生素有亚胺培南、头孢哌酮/舒巴坦、阿米卡星等;对铜绿假单胞菌较敏感的抗生素有亚胺培南、头孢吡肟、阿米卡星等。革兰阴性菌中检出产超广谱β-内酰胺酶(ESBLs)菌共3株,其中肺炎克雷伯杆菌2株,大肠埃希菌1株。结论脑卒中患者并发肺部感染的病原体主要为革兰阴性菌,应控制抗生素的滥用,以减少耐药菌株的产生。
目的:探討老年腦卒中相關性肺炎病原菌分佈及對抗生素的耐藥性。方法選擇腦卒中相關性肺炎的老年患者231例,進行痰培養及藥敏試驗,併分析。結果135例患者檢齣病原體,總暘性率為58.44%,其中包括革蘭陰性菌共86株(63.70%),革蘭暘性菌共23株(17.03%),真菌26株(19.26%),其中混閤感染佔18.51%。革蘭陰性菌中主要包括:肺炎剋雷伯桿菌有27株(20.0%),鮑曼不動桿菌17株(12.60%),銅綠假單胞菌14株(10.37%)。革蘭暘性菌中包括金黃色葡萄毬菌13株(9.63%),肺炎鏈毬菌7株(5.19%),凝固酶暘性葡萄毬菌3株(2.22%)。真菌中白假絲酵母菌最為多見,有17株(12.0%)。對肺炎剋雷伯桿菌敏感的抗生素有亞胺培南、頭孢吡肟等;對鮑曼不動桿菌較敏感的抗生素有亞胺培南、頭孢哌酮/舒巴坦、阿米卡星等;對銅綠假單胞菌較敏感的抗生素有亞胺培南、頭孢吡肟、阿米卡星等。革蘭陰性菌中檢齣產超廣譜β-內酰胺酶(ESBLs)菌共3株,其中肺炎剋雷伯桿菌2株,大腸埃希菌1株。結論腦卒中患者併髮肺部感染的病原體主要為革蘭陰性菌,應控製抗生素的濫用,以減少耐藥菌株的產生。
목적:탐토노년뇌졸중상관성폐염병원균분포급대항생소적내약성。방법선택뇌졸중상관성폐염적노년환자231례,진행담배양급약민시험,병분석。결과135례환자검출병원체,총양성솔위58.44%,기중포괄혁란음성균공86주(63.70%),혁란양성균공23주(17.03%),진균26주(19.26%),기중혼합감염점18.51%。혁란음성균중주요포괄:폐염극뢰백간균유27주(20.0%),포만불동간균17주(12.60%),동록가단포균14주(10.37%)。혁란양성균중포괄금황색포도구균13주(9.63%),폐염련구균7주(5.19%),응고매양성포도구균3주(2.22%)。진균중백가사효모균최위다견,유17주(12.0%)。대폐염극뢰백간균민감적항생소유아알배남、두포필우등;대포만불동간균교민감적항생소유아알배남、두포고동/서파탄、아미잡성등;대동록가단포균교민감적항생소유아알배남、두포필우、아미잡성등。혁란음성균중검출산초엄보β-내선알매(ESBLs)균공3주,기중폐염극뢰백간균2주,대장애희균1주。결론뇌졸중환자병발폐부감염적병원체주요위혁란음성균,응공제항생소적람용,이감소내약균주적산생。
Objective To investigate the pathogen distribution and antibiotic resistance of stroke-associated pneumonia in elderly pa-tients. Methods A total of 231 elderly patients with stroke-associated pneumonia were collected. Sputum culture and susceptibility test was taken and the results were analyzed. Results Pathogens were detected in 135 patients,with the total positive rate of 58. 44%,including 86 iso-lates of Gram-negative bacteria(63. 70%),23 isolates of Gram-positive bacteria(17. 03%)and 26 isolates of fungi(19. 26%). Mixed in-fections accounted for 18.51%. Gram -negative bacteria mainly included Klebsiella pneumoniae(K. pneumoniae)(27 isolates,20. 0%), Acinetobacter baumannii(A. baumannii)(17 isolates,12. 60%),and Pseudomonas aeruginosa(P. aeruginosa)(14 isolates,10. 37%). Gram-positive bacteria included Staphylococcus aureus(13 isolates,9. 63%),Streptococcus pneumoniae(7 isolates,5. 19%),and coagulase-positive staphylococci(3 isolates,2. 22%). Candida albicans is the most common fungus(17 isolates,12. 0%). The susceptibility test showed that the isolates of K. pneumoniae was sensitive to imipenem,cefepime,etc;A. baumannii was sensitive to imipenem,cefoperazone/sul-bactam,amikacin,etc.;P. aeruginosa was sensitive to imipenem,cefepime,amikacin and so on. Extended spectrum β-lactamases( ESBLs) producing Gram-negative bacteria were identified in two isolates of K. pneumoniae and one isolate of Escherichia coli. Conclusion The patho-gens responsible for the stroke-associated pneumonia were mainly Gram-negative. Overuse of antibiotics should be controlled in order to reduce the generation of resistant strains.