老年脑卒中患者合并肺部感染病原菌分布和耐药性及危险因素分析  

Analysis of pathogen distribution and drug resistance and risk factors of pulmonary infection in elderly stroke patients

作　　者：周立峰[1] 李迪[1] 凌军[1] 李群伟[1] ZHOU Li-feng LI Di LING Jun LI Qun-wei(Department of Neurology,Lishui Traditional Chinese Medical Hospital, Lishui , Zhejiang 323000, Chin)

机构地区：[1]丽水市中医院神经内科,浙江丽水323000

出　　处：《中国卫生检验杂志》2016年第20期3019-3021,3024,共4页Chinese Journal of Health Laboratory Technology

摘　　要：目的探讨老年脑卒中患者肺部感染病原菌类型、耐药性及肺部感染相关因素。方法回顾性分析2011年3月-2014年12月286例老年脑卒中患者临床资料,分析感染病原菌类型、主要病原菌耐药性及肺部感染危险因素。结果286例老年脑卒中患者肺部感染率为22.73%,共检出病原菌86株,其中革兰阴性菌、革兰阳性菌、真菌分别为52株、28株、6株,各占60.47%、32.56%、6.98%。除铜绿假单胞菌对美罗培南、亚胺培南耐药率为0,金黄色葡萄球菌对万古霉素、替考拉宁耐药率为0,其他病原菌显示多药耐药;Logistic回归分析发现住院时间、意识障碍、合并糖尿病、机械通气等因素是发生肺部感染的独立危险因素,差异均具有统计学意义(P<0.05)。结论老年脑卒中患者医院发生肺部感染相关危险因素较多,应采取对应措施控制危险因素,有针对性选择抗菌药物。Objective To explore the pathogenic types,drug resistance and pulmonary infection related factors in elderly stroke patients. Methods Clinical data of 286 stoke patients were conducted for retrospectively analysis from March 2011 to December 2014. The pathogenic bacteria types,the main pathogen resistance,pulmonary infection risk factors were analyzed.Results The pulmonary infection rate of 286 elder patients with stroke was 22. 73%,and 86 pathogens were detected,including 52 strains of gram- negative bacteria（ 60. 47%）,28 strains of Gram- positive bacteria（ 32. 56%）,6 strains of fungal（ 6. 98%）; resistance rate of Pseudomonas aeruginosa to meropenem and imipenem was 0,and resistance rate of Staphylococcus aureus to vancomycin,teicoplanin was 0,other pathogens showed multi- drug resistance. Logistic regression analysis showed that hospitalization time,unconsciousness,diabetes,mechanical ventilation and other factors were independent risk factors for lung infection,with the differences statistically significant（ P〈 0. 05）. Conclusion The risk factors associated with lung infection in elderly patients with stroke are more,so it should take corresponding measures to control the risk factors and to target selection of antimicrobial drugs in clinical.

关 键 词：脑卒中 肺部感染 病原菌 危险因素 

分 类 号：R743.3[医药卫生—神经病学与精神病学]