脑血管病后遗症患者院外下呼吸道感染分析  

Community-acquired Lower Respiratory Infection in Older Patients with Cerebrovascular Disease Sequelae:Bacterial Etiology and Resistance Analysis

作　　者：王勇[1] 谷丽[1] 张捷[1] 潘磊[1] 

机构地区：[1]北京世纪坛医院,北京100038

出　　处：《中华医院感染学杂志》2007年第4期401-402,共2页Chinese Journal of Nosocomiology

摘　　要：目的分析脑血管病后遗症患者下呼吸道感染的细菌病原学及药物敏感性,为临床使用抗菌药物提供依据。方法回顾性调查2003-2005年,医院呼吸科收治的320例发生下呼吸道感染的老年脑血管病后遗症患者。结果老年脑血管病后遗症患者下呼吸道院外感染以革兰阴性杆菌(60.41%)为主,其中铜绿假单胞菌占首位,其次为克雷伯菌属(13.20%)和大肠埃希菌(9.12%),革兰阳性球菌中以耐甲氧西林金黄色葡萄球菌为主(17.12%),除此之外,真菌感染增加,以白色假丝酵母菌为主(10.30%);革兰阴性杆菌对亚胺培南的抗菌性最强。结论老年脑血管病后遗症患者下呼吸道院外感染为多种耐药致病菌的混合感染。OBJECTIVE To investigate the pathogen spectrum and resistance in older cerebrovascular patients with sequelae, so as to provide the evidence for antibiotic applied clinically in these patients. METHODS Retrospective survey of 320 cerebrovascular patients with lower respiratory infection admitted in respiration department from 2003 to 2004 was conducted. RESULTS The occurrence of Gram-negative bacilli （60. 41%） in cerebrovascular patients with lower respiratory infection was obviously high, among which the first places were Pseudomonas aeruginosa （24.03 % ）, Klebsiella pneumoniae （13.20 % ） and Escherichia coli （9.12 % ）, respectively. The Gram - positive bacteria mainly included oxacillin-resistant Staphylococcus aureus （17.12 % ）. In addition, the occurrence rate of fungal infection was increasing, Candida albicans was still the most frequent one （10. 30%）. The imipenem was the most sensitive to Gram-negative bacilli and more superior than the cefoperazone/sulbactam and ceftazidime. The oxacillcin-resistant S. aureus was still susceptive to vancomycin. CONCLUSIONS The community-acquired lower respiratory infection in older cerebrovascular patients with sequelae is mixed with multi- resistant bacteria.

关 键 词：脑血管病 下呼吸道感染 致病菌 耐药性 

分 类 号：R749.1[医药卫生—神经病学与精神病学]