老年脑卒中恢复期患者医院获得性肺炎细菌耐药性分析  

Antibiotic resistance of pathogenic bacteria in elderly stroke patients with hospital-acquired pneumonia at recovery stage

作　　者：徐卫刚[1] 徐亚伟[2] 

机构地区：[1]同济大学医学院临床一系,上海200092 [2]同济大学附属上海市第十人民医院心内科,上海200072

出　　处：《中华医院感染学杂志》2011年第21期4594-4596,共3页Chinese Journal of Nosocomiology

摘　　要：目的探讨老年脑卒中恢复期患者医院获得性肺炎(HAP),病原菌分布及耐药状况。方法对2007-2009年,394例确诊HAP的老年脑卒中恢复期患者,痰送检标本进行回顾性分析,药敏采用K-B纸片法,WHO-NET 5.4软件进行统计。结果脑卒中后遗症患者HAP细菌学检出率为60.9%;检出的266株病原菌中,排在前4位是铜绿假单胞菌占24.8%、肺炎克雷伯菌占19.2%、金黄色葡萄球菌占16.5%、大肠埃希菌占15.4%;产ESBLs的大肠埃希菌和肺炎克雷伯菌检出率为51.2%和35.3%;MRSA检出率为72.7%。结论老年脑卒中恢复期患者HAP病原菌以革兰阴性菌为主,其耐药性高,头孢哌酮/舒巴坦和万古霉素是其较为理想的药物。OBJECTIVE To analyze the distribution and antibiotic resistance of common pathogenic bacteria in the stroke elderlies at recovery stage Suffered from HAP. METHODS A total of 394 elderly stroke patients at recovery stage suffered from HAP from Jan 2007 to Dec 2009 were retrospectively analyzed the commonly encountered pathogens and their antibiotic resistance. Microbial sensitivity tests were determined by K-B disk diffusion method and data analyzed by WHONETS. 4. RESULTS Bacteriology detection of these patients was 60.9 %. A total of 266 strains bacteria were isolated. The top four clinical isolates of bacteria were P. aeruginosa（24.8%）, Klebsiella pneumoniae（19. 2% ） , Staphylococcus aureus（ 1 6. 5% ） , E. coli（15. 4 %）. The prevalence of ESBLs of E. col i and K. pneumonia were 51. 2% and 35. 3%. The prevalence of MRSA was 72. 7%. CONCLUSION Gram- negative bacteria are the main pathogens in the stroke elderly at recovery stage suffered from HAP. The strains show high resistance. Cefoperazone sulbactam and vancomycin was the ideal choice in these group.

关 键 词：老年患者 医院获得性肺炎 脑卒中恢复期 耐药性 病原菌 超广谱Β-内酰胺酶 

分 类 号：R378[医药卫生—病原生物学]