CAJ | 학술논문

目的：探讨脑梗死患者下呼吸道感染的病原菌分布及耐药特点，为临床治疗提供参考。方法选取2013年1月－2014年6月300例脑梗死下呼吸道感染患者，检测其病原菌分布，并实施耐药性检测。结果300例感染患者共分离出病原菌422株，其中革兰阴性菌315株占74．64％，以肺炎克雷伯菌、铜绿假单胞菌为主，革兰阳性菌60株占14．22％，以金黄色葡萄球菌为主，真菌47株占11．14％，以白色假丝酵母菌为主；革兰阴性菌对头孢哌酮／舒巴坦、哌拉西林／他唑巴坦、呋喃妥因等耐药率较低，为4．76％～27．78％，亚胺培南耐药率均＜6．00％；革兰阳性菌对万古霉素、利福平耐药率较低，其中对万古霉素无耐药性；白色假丝酵母菌对伏立康唑、氟胞嘧啶耐药率较低。结论脑梗死下呼吸道感染率高，革兰阴性菌是主要菌种，同时耐药性复杂，临床要加强抗菌药物管理与耐药性监测。
목적：탐토뇌경사환자하호흡도감염적병원균분포급내약특점，위림상치료제공삼고。방법선취2013년1월－2014년6월300례뇌경사하호흡도감염환자，검측기병원균분포，병실시내약성검측。결과300례감염환자공분리출병원균422주，기중혁란음성균315주점74．64％，이폐염극뢰백균、동록가단포균위주，혁란양성균60주점14．22％，이금황색포도구균위주，진균47주점11．14％，이백색가사효모균위주；혁란음성균대두포고동／서파탄、고랍서림／타서파탄、부남타인등내약솔교저，위4．76％～27．78％，아알배남내약솔균＜6．00％；혁란양성균대만고매소、리복평내약솔교저，기중대만고매소무내약성；백색가사효모균대복립강서、불포밀정내약솔교저。결론뇌경사하호흡도감염솔고，혁란음성균시주요균충，동시내약성복잡，림상요가강항균약물관리여내약성감측。
OBJECTIVE To explore the distribution and drug resistance of the pathogens causing lower respiratory tract infections in the patients with cerebral infarction so as to provide guidance for clinical treatment .METHODS A total of 300 cerebral infarction patients with lower respiratory tract infections who were treated in the hospital from Jan 2013 to Jun 2014 were enrolled in the study ,then the distribution of pathogens was investigated ,and the drug resistance was detected .RESULTS Totally 422 strains of pathogens have been isolated from the 300 patients with infections ,including 315 (74 .64% ) strains of gram‐negative bacteria ,60 (14 .22% ) strains of gram‐positive bacteria ,and 47 (11 .14% ) strains of fungi;the K lebsiella pneumoniae and Pseudomonas aeruginosa were domi‐nant among the gram‐negative bacteria;the Staphylococcus aureus was the predominant species of gram‐positive bacteria ;the Candida albicans was dominant among the fungi .The drug resistance rates of the gram‐negative bac‐teria to cephoperazone‐sulbactam ,piperacillin‐tazobactam ,and nitrofurantoin varied from 4 .76% to 27 .78% ,and the drug resistance rate to imipenem was less than 6 .00% .The drug resistance rates of the gram‐positive bacteria to vancomycin and rifampicin were relatively low ,and the drug resistance rate to vancomycin was 0 .The drug re‐sistance rates of the C .albicans to voriconazole and fluorocytosine were relatively low .CONCLUSION The incidence of lower respiratory tract infections is high in the patients with cerebral infarction ;the gram‐negative bacteria are the predominant pathogens ,and the drug resistance is complex .It is necessary for the hospital to strengthen the management of antibiotics and the surveillance of drug resistance .