中外医疗
中外醫療
중외의료
CHINA FOREIGN MEDICAL TREATMENT
2015年
16期
60-61,64
,共3页
脑卒中%医院获得性肺炎%病原菌%耐药性
腦卒中%醫院穫得性肺炎%病原菌%耐藥性
뇌졸중%의원획득성폐염%병원균%내약성
Stroke%Hospital-acquired pneumonia%Pathogenic bacteria%Drug resistance
目的：分析该院重症脑卒中患者继发医院获得性肺炎的病原菌分布特点及耐药情况。方法整群选取该院2012年1月-2014年10月收治的178例重症脑卒中继发医院获得性肺炎患者，对其痰培养及药敏试验结果进行回顾性分析。结果178例肺部感染患者痰培养阳性143例，阳性率80.3%，病原菌共230株。其中革兰氏阴性菌159例，占69.13%；革兰氏阳性菌53例，占23.04%；真菌18例，占7.83%。革兰氏阳性菌对万古霉素、替考拉宁全部敏感。革兰氏阴性菌对头孢吡肟、亚胺培南、阿米卡星、哌拉西林/他唑巴坦及头孢哌酮/舒巴坦均较敏感。结论重症脑卒中合并肺部感染患者以革兰氏阴性菌为主，且存在多重耐药性，及时行痰培养及药敏试验，依据结果合理选择抗生素，避免、控制耐药菌医院感染的发生。
目的：分析該院重癥腦卒中患者繼髮醫院穫得性肺炎的病原菌分佈特點及耐藥情況。方法整群選取該院2012年1月-2014年10月收治的178例重癥腦卒中繼髮醫院穫得性肺炎患者，對其痰培養及藥敏試驗結果進行迴顧性分析。結果178例肺部感染患者痰培養暘性143例，暘性率80.3%，病原菌共230株。其中革蘭氏陰性菌159例，佔69.13%；革蘭氏暘性菌53例，佔23.04%；真菌18例，佔7.83%。革蘭氏暘性菌對萬古黴素、替攷拉寧全部敏感。革蘭氏陰性菌對頭孢吡肟、亞胺培南、阿米卡星、哌拉西林/他唑巴坦及頭孢哌酮/舒巴坦均較敏感。結論重癥腦卒中閤併肺部感染患者以革蘭氏陰性菌為主，且存在多重耐藥性，及時行痰培養及藥敏試驗，依據結果閤理選擇抗生素，避免、控製耐藥菌醫院感染的髮生。
목적：분석해원중증뇌졸중환자계발의원획득성폐염적병원균분포특점급내약정황。방법정군선취해원2012년1월-2014년10월수치적178례중증뇌졸중계발의원획득성폐염환자，대기담배양급약민시험결과진행회고성분석。결과178례폐부감염환자담배양양성143례，양성솔80.3%，병원균공230주。기중혁란씨음성균159례，점69.13%；혁란씨양성균53례，점23.04%；진균18례，점7.83%。혁란씨양성균대만고매소、체고랍저전부민감。혁란씨음성균대두포필우、아알배남、아미잡성、고랍서림/타서파탄급두포고동/서파탄균교민감。결론중증뇌졸중합병폐부감염환자이혁란씨음성균위주，차존재다중내약성，급시행담배양급약민시험，의거결과합리선택항생소，피면、공제내약균의원감염적발생。
Objective To analyze the distribution and drug resistance of pathogenic bacteria causing hospital-acquired pneumonia (HAP) in severe stroke patients. Methods The results of pecimen culture and drug resistance test of 178 severe stroke patients with hospital- acquired pneumonia admitted to our hospital from January 2012 to Octomber 2014 were retrospectively analyzed. Results Of 178 of HAP positive sputum culture 143 cases, sputum specimen culture positive rate was 80.3%.Of total 230 strains of pathogens isolated from sputum specimen ,there were 159(69.13%)strains of gram-negative bacteria, 53(23.04%) strains of gram-positive bacteria,and 18 (7.83%) strains of fungi. Gram-positive bacteria was sensitive to vancomycin andteicoplanin. Gram-nega-tive bacteria were sensitive to cefepime, imipenem, amikacin, piperacillin / tazobactam and cefoperazone / sulbactam. Conclusion Gram -negative bacteria is predominant in severe stroke patients with HAP. Drug resistance is very serious, and the antibiotics should be selected in clinic according to the result of drug susceptibility test. It is necessary for the medical staff to take compre-hensive interventions so as to prevent and control the Hospital-acquired pneumonia.
