脑梗死患者下呼吸道感染病原学特点分析  

Etiological characteristics of lower respiratory tract infections in patients with cerebral infarction

作　　者：范伟女[1] 姜雅芬[1] 俞虎[1] 严旺[1] 

机构地区：[1]宁波市第二医院神经内科,浙江宁波315000

出　　处：《中华医院感染学杂志》2015年第10期2205-2207,共3页Chinese Journal of Nosocomiology

基　　金：浙江省医药卫生科技计划基金资助项目(2012KYB143)

摘　　要：目的：探讨脑梗死患者下呼吸道感染的病原菌分布及耐药特点，为临床治疗提供参考。方法选取2013年1月－2014年6月300例脑梗死下呼吸道感染患者，检测其病原菌分布，并实施耐药性检测。结果300例感染患者共分离出病原菌422株，其中革兰阴性菌315株占74．64％，以肺炎克雷伯菌、铜绿假单胞菌为主，革兰阳性菌60株占14．22％，以金黄色葡萄球菌为主，真菌47株占11．14％，以白色假丝酵母菌为主；革兰阴性菌对头孢哌酮／舒巴坦、哌拉西林／他唑巴坦、呋喃妥因等耐药率较低，为4．76％～27．78％，亚胺培南耐药率均＜6．00％；革兰阳性菌对万古霉素、利福平耐药率较低，其中对万古霉素无耐药性；白色假丝酵母菌对伏立康唑、氟胞嘧啶耐药率较低。结论脑梗死下呼吸道感染率高，革兰阴性菌是主要菌种，同时耐药性复杂，临床要加强抗菌药物管理与耐药性监测。OBJECTIVE To explore the distribution and drug resistance of the pathogens causing lower respiratory tract infections in the patients with cerebral infarction so as to provide guidance for clinical treatment .METHODS A total of 300 cerebral infarction patients with lower respiratory tract infections who were treated in the hospital from Jan 2013 to Jun 2014 were enrolled in the study ,then the distribution of pathogens was investigated ,and the drug resistance was detected .RESULTS Totally 422 strains of pathogens have been isolated from the 300 patients with infections ,including 315 （74 .64% ） strains of gram‐negative bacteria ,60 （14 .22% ） strains of gram‐positive bacteria ,and 47 （11 .14% ） strains of fungi;the K lebsiella pneumoniae and Pseudomonas aeruginosa were domi‐nant among the gram‐negative bacteria;the Staphylococcus aureus was the predominant species of gram‐positive bacteria ;the Candida albicans was dominant among the fungi .The drug resistance rates of the gram‐negative bac‐teria to cephoperazone‐sulbactam ,piperacillin‐tazobactam ,and nitrofurantoin varied from 4 .76% to 27 .78% ,and the drug resistance rate to imipenem was less than 6 .00% .The drug resistance rates of the gram‐positive bacteria to vancomycin and rifampicin were relatively low ,and the drug resistance rate to vancomycin was 0 .The drug re‐sistance rates of the C .albicans to voriconazole and fluorocytosine were relatively low .CONCLUSION The incidence of lower respiratory tract infections is high in the patients with cerebral infarction ;the gram‐negative bacteria are the predominant pathogens ,and the drug resistance is complex .It is necessary for the hospital to strengthen the management of antibiotics and the surveillance of drug resistance .

关 键 词：脑梗死 下呼吸道 感染 病原菌 耐药 

分 类 号：R378[医药卫生—病原生物学]