重症脑卒中患者多药耐药菌感染的调查分析

目的调查重症脑卒中患者多药耐药菌的感染情况，为预防和控制多药耐药菌的感染提供科学依据。方法对2010年1月至2013年10月本科室收治的92例并发多药耐药菌感染的重症脑卒中患者临床资料和病原菌感染情况，采用回顾性方法进行分析。结果本科室重症脑卒中患者并发多药耐药菌感染率为3．59％（92／2564），共分离培养多药耐药菌株92株，依次为产超广谱β-内酰胺酶肺炎克雷伯菌、大肠埃希菌、耐甲氧西林金黄色葡萄球菌、铜绿假单胞菌和鲍曼不动杆菌，分别占48．91％（45／92）、33．69％（31／92）、6．52％（6／92）、5．43％（5／92）和3．26％（3／92）。感染标本主要来自痰液和尿液，分别占44．57％（41／92）和31．52％（29／92）。结论对重症脑卒中并发多药耐药菌感染的患者，应针对引发耐药菌株产生的薄弱环节，加强监测，并采取切实、有效措施，预防和控制多药耐药菌感染的发生。

Investigation and analysis on multiple drug resistant infections in severe patients with stroke diseases

Objective To investigate the status of multidrug-resistant bacteria infections in patients with severe stroke diseases, and provide scientific basis for the prevention and control of the multidrugresistant bacteria infections. Methods A total of 92 cases with multidrug-resistant bacteria infections and severe stroke from January 2010 to October 2013 were enrolled, then the clinical data and the situation of pathogenic bacteria infections were analyzed, retrospectively. Results In our department, the rate of multidrug-resistant bacteria infections with severe stroke diseases was 3.59% （92/2 564）. A total of 92 strains of pathogens were isolated, among which the most was producing extended spectrum beta lactamases Klebsiella pneumoniae, followed by Escherichia coli, methicillin-resistant Staphylococcus aureus, Pseudomonas aeruginosa and Aeinetobacter baumannii, accounting for 48.91% （45/92）, 33.69% （31/92）, 6.52% （6/92）, 5.43% （5/92） and 3.26% （3/92）, respectively. Infected samples were mainly from sputum and urine, accounting for 44.57% （41/92） and 31.52% （29/92）. Conclusions For the patients with severe stroke complicating multidrug-resistant bacteria infections, it is should lead to resistant strains against the weak links, strengthen the monitoring, and taking practical, effective measures, so as to prevent and control the multidrug-resistant bacteria infections.