文章摘要
辛丽云 陈乾华 潘娜 牛小红 耿荣华.脑卒中患者医院获得性肺炎的病原菌分布及药敏分析[J].,2016,16(21):4096-4099
脑卒中患者医院获得性肺炎的病原菌分布及药敏分析
Pathogenic Bacterial Distribution and It's Drug Resistance Analysis of StrokePatients with Hospital Acquired Pneumonia
  
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中文关键词: 脑卒中  医院获得性肺炎  病原菌  分布  耐药性
英文关键词: Hospital acquired pneumonia  Pathogenic bacteria  Distribution  Drug resistance
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辛丽云 陈乾华 潘娜 牛小红 耿荣华 中国医科大学航空总医院呼吸科中国医科大学航空总医院检验科 
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中文摘要:
      目的:分析脑卒中患者医院获得性肺炎的病原菌分布及药敏性,为临床合理使用抗菌药物提供依据。方法:收集2013 年3 月-2015 年9月我院收治的109 例脑卒中并发医院获得性肺炎的临床资料,采用无菌方法收集患者晨痰或者下呼吸道分泌物进 行细菌培养,并对阳性病原菌进行药物敏感性试验。结果:对痰标本或者是下呼吸道分泌物进行细菌培养187 次,培养阳性152 次,阳性率为81.28%,共培养出病原菌283 株,其中革兰阴性菌192 株占67.84%,革兰阳性菌76 株占26.86%,真菌15 株占 5.30%。革兰阴性菌中的肺炎克雷伯菌,鲍氏不动杆菌,大肠埃希菌,铜绿假单胞菌,阴沟肠杆菌对头孢噻肟,头孢呋辛,美洛西林, 美洛西林,头孢呋辛和头孢噻肟的耐药率最高,分别为66.18%,65.31%,70.97%,64.00%,71.43%;对氯霉素,哌拉西林/ 他唑巴坦, 氯霉素,头孢吡肟,氯霉素的耐药率最低,分别为1.47%,6.12%,3.23%,8.00%,7.14%。革兰阳性菌中的金黄色葡萄球菌,肺炎链球 菌,粪肠球菌对万古霉素,万古霉素,氨苄西林的耐药率最高,分别100.00%,90.00%,84.62%;对红霉素,红霉素,红霉素的耐药率 最低,分别为5.26%,0.00%,0.00%。结论:革兰阴性菌是脑卒中患者医院获得性肺炎的主要病原菌,病原菌耐药性高且存在耐多 药现象,临床应合理选用抗菌药物进行治疗。
英文摘要:
      Objective:To analysis the distribution and drug resistance of pathogenic bacteria in patients with stroke combined with hospital acquired pneumonia, to provide laboratory reference for clincal retional selection of antibiotics.Methods:109 stroke patients with hospital acquired pneumonia in our hospital fromMarch 2013 to September 2015 were investigated, and bacterial culture of morning sputum or lower respiratory tract secretion collected by aseptic method were conducted, and the the drug resistance test of positive pathogenic bacteria were carried out.Results:187 times of bacterial culture of morning sputum or lower respiratory tract secretion in 109 patients were launched, and 152 positive times (81.28%) including 283 strains of pathogenic bacteria, in which 192 strains of gram negative bacilli (67.82%), 76 strains of grampositive bacilli (26.86%), and 15 strains of fungi (5.30%). Among the gram negative bacilli, the drug resistance of , , , , to cefotaxime, cefuroxime, mezlocillin, mezlocillin, cefuroxime and cefotaxime were the highest(66.18%, 65.31%, 70.97%, 64.00%, 71.43%respectively). The drug resistance to chloramphenicol, piperacillin/tazobactam, chloramphenicol, cefepime, chloramphenicol were the lowest (1.47%, 6.12%, 3.23%, 8.00%, 7.14%respectively). Among the the gram positive bacteria, the drug resistance of , , to vancomycin, vancomycin, ampicillin were the highest (100.00%, 90.00%, 84.62%respectively). The drug resistance to erythromycin, erythromycin, erythromycin were the lowest (5.26%, 0.00%, 0.00%respectively).Conclusion:Gram negative bacilli is the main pathogenic bacteria in stroke patients with hospital acquired pneumonia in our hospital. The pathogenic bacteria have a characteristics of high drug resistance and multiple drug resistance. It is should do that rational selection of antibacterials to treatment in clinic.
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