老年急性脑卒中患者并发肺部感染病原学及药敏分析  

Pathology of complicated pulmonary infection in patients with acute stroke and drug sensitivity

作　　者：陈洁芳[1] 邬至平[1] 邱伟文[1] 

机构地区：[1]温州医学院附属第五医院丽水市中心医院神经内科,浙江丽水323000

出　　处：《中华医院感染学杂志》2011年第1期172-174,共3页Chinese Journal of Nosocomiology

摘　　要：目的探讨老年急性脑卒中患者并发肺部感染的病原学特点、药物敏感及耐药性,为临床治疗提供依据。方法前瞻性采用ATB鉴定法和药敏测试仪检测老年急性脑卒中患者并发肺部感染痰培养细菌学及药物敏感特性。结果 758例老年急性脑卒中患者中肺部感染率为34.7%,分离病原菌322株,其中革兰阴性菌占75.5%,以肺炎克雷伯菌为主,对头孢哌酮/舒巴坦最敏感;革兰阳性菌占15.5%,以金黄色葡萄球菌为主,对利奈唑胺、万古霉素最敏感;真菌占9.0%,对氟康唑最敏感。结论老年卒中患者肺部感染率高,应积极预防感染,加强病原学监测,合理选用抗菌药物。OBJECTIVE To explore the characteristics of drug resistance of the pathogens in elderly patients after acute stroke associated with pulmonary infection, so as to offer evidences for the clinical treatment. METHODS In a prospective study, 263 elderly patients after acute stroke associated with pulmonary infection. ATB Expression approach was applied to test the bacterial strains in phlegm bacterial culture and also used antimicrobial susceptibility test instrument to analyze the antimicrobial susceptibility. RESULTS The incidence of pulmonary infection was 34.7%, there were 322 strains of pathogens. The Gram-negative bacilli accounted for 75.5 %. The Gram-positive bacteria accounted for 15. 5% and the fungi was 9.0%. G^- bacteria mainly included Klebsiella pneumoniae, G^＋ bacteria mainly included Staphlococcus aureus. The most Gram-negative bacilli were highly susceptible to Cefoperazone/sulbactam. Gram-positive bacilli were highly susceptible to linezolid and vancomycin. Fungi were highly susceptible to fluconazole. CONCLUSION The incidence of pulmonary infection in elderly patients after acute stroke is high. The infection should be actively prevented. The monitoring to pathogens should be strengthened and the antibiotic should be chosen reasonably.

关 键 词：脑卒中 肺部感染 病原学 

分 类 号：R378[医药卫生—病原生物学]