402例卒中相关性肺炎痰细菌培养及药敏结果分析  

Analysis of sputum culture and drug sensitivity of 402 stroke associated pneumonia patients

作　　者：孙世中[1] 杨彩凤[2] 李建军[2] 吴绘[2] 马铁柱[2] 

机构地区：[1]武警医学院附属医院脑系科神经ICU/亚低温治疗中心,天津300162 [2]武警医学院附属医院脑系科,天津300162

出　　处：《武警医学院学报》2011年第1期24-26,共3页Acta Academiae Medicinae CPAPF

摘　　要：【目的】分析卒中相关性肺炎患者痰培养细菌分布及药敏情况,为临床合理运用抗菌药治疗提供参考依据。【方法】对402例卒中相关性肺炎患者的痰标本进行细菌培养及药敏试验。【结果】共检出细菌228株,检出率为56.7%。其中革兰阳性菌61株,占26.8%,排在前三位的是金葡菌(12.3%)、肺炎链球菌(7.9%)、β溶血性链球菌(3.9%);革兰阴性菌158株,占69.3%,排在前三位的是肺炎克雷伯杆菌(30.3%)、鲍曼不动杆菌(11.0%)、铜绿假单胞菌(9.6%);革兰阳性菌对青霉素、红霉素耐药率高,对万古霉素敏感;革兰阴性菌对氨苄西林耐药率最高,但对碳青霉烯类、氨基糖苷类、喹诺酮类抗菌药物具有较高敏感性。【结论】卒中相关性肺炎患者机体免疫力低,感染细菌种类广泛,在用药方面应根据病原菌及药敏情况选择安全、有效的抗菌药。【Objective】Understanding the patients of SAP with Sputum Culture and Drug Sensitivity for rational use of drug.【Methods】 Samples of 402 cases of SAP were cultured and drug sensitivity test was performed.【Results】 A total of 228 strains of micro-organisms were isolated,the positive rate was 56.7%.61 were Gram-positive bacteria which accounted for 26.8% and 158 were Gram-negative bacteria which accounted for 69.3%.The main Gram-positive bacteria were S.aureus（12.3%）,S.pneumoniae（7.9%） and Beta-hemolytic Streptococcus（3.9%）.The main Gram-negative bacteria were K.pneumoniae（30.3%）,A.baumanii（11.0%）and P.aeruginosa（9.6%）.The drug sensitivity test results indicated that the drug resistance rate of Gram-positive bacteria against penicillin and erythromycin were high,but they were sensitive to vancomycin.The drug resistance rate of Gram-negative bacteria against ampicillin was the highest,however,they were sensitive to carbopenems,aminoglycosides and quinolones antibiotics.【Conclusion】 The SAP patients＇ immune function are decreased and the pathogens are wide distributed,clinicians should pay attention to the culture of pathogens and drug sersitivity analysis and rational use of drug.

关 键 词：卒中相关性肺炎 病原体 合理用药 

分 类 号：R446.5[医药卫生—诊断学]