卒中相关性肺炎病原菌分布及耐药性分析

目的 探讨卒中相关性肺炎患者的病原菌分布及其耐药情况,为临床合理选用抗菌药物提供依据.方法 运用回顾性研究的方法对188例卒中相关性肺炎患者的病原菌分布及药敏试验结果进行分析.结果 119例患者检出致病菌,阳性检出率为63.3％(119/188);共分离出病原菌143株,以革兰阴性菌为主,占74.1％;混合感染24例,占20.2％(24/119);前五位的病原菌依次为:肺炎克雷伯菌、铜绿假单胞菌、鲍曼不动杆菌、嗜麦芽窄食单胞菌及金黄色葡萄球菌;革兰阴性菌对常用的抗菌药物表现出很高的耐药性.结论 革兰阴性菌是卒中相关性肺炎的主要致病菌,临床医生应根据病原菌及药敏试验选择安全、有效的抗菌药物,以减少耐药菌的产生.

Distribution and drug-resistance of pathogens in patients with stroke-associated pneumonia

Objective To analyze the distribution and drug resistance of pathogens in patients with stroke-associated pneumonia (SAP) and provide some references for the clinical application of antibiotics.Methods A retrospective investigation was performed to analyze the pathogens and the drug resistance of 188 patients with SAP.Results Pathogens were detected in 119 patients,with a total positive rate of 63.3％ (119/188).Among the 143 strains of isolated pathogens,Gram-negative bacteria accounted for 74.1％ and mixed infections accounted for 20.2％.The top five pathogens were Klebsiella pneumoniae,Pseudomonas aeruginosa,Acinetobacter baumannii,Stenotrophomonas maltophilia,and Staphylococcus aureus.Gram-positive bacteria had varied degrees of resistance to commonly used antibiotics.Conclusions Gram-negative bacteria are the main dominant bacteria in SAP;safe and effective antibiotics should be selected in clinic according to the results of drug susceptibility test.