脑卒中并发肺部感染病原学及药物敏感性分析

目的 探索脑卒中并发肺部感染病原学及药物敏感性，指导临床合理选用抗菌药物。方法 前瞻性采用ATB鉴定法和药敏测试仪检测痰培养细菌学及药敏特性。结果 56例脑卒中并发肺部感染患者，痰培养检出菌株146例。其中以革氏阴性杆菌(G杆菌)为主(占57．53％)，其次为革兰氏阳性球菌(G^ 球菌)(占31．5l％)和真菌(10．96％)。G^-杆菌以肺炎克雷伯菌最多，其次为人肠埃希菌；G^-球菌中以金黄色葡萄球和溶血性葡萄球菌最多；真菌则以启假丝酵母菌最多。体外药敏显示G^-菌对亚胺培南／西司他丁、哌拉西林／他唑巴坦敏感性较高，G^-球菌对万古霉素最为敏感。真菌对5-氟胞嘧啶和两性素B较敏感。其他抗生素普遍耐药。结论 G^—／杆菌仍是脑卒中并发肺部感染患者最主要的致病菌，治疗上宜首选亚胺培南／西司他丁、哌拉西林／他唑巴坦。

The pathogenicity and antimicrobial susceptibility of complicated pulmonary infection in stroke

Obejective To study the pathogenicity and antimicrobial susceptib il ity of complicated pul-monary infection in stroke.Methods In a prospec-tive stud y of56patients with cere-brovascular ac-cident complicated by pulmonary infecti on,we ap-plied ATB Expression approach to test the bacteri-al strains in phlegm bacterial culture and also used antimicrobial susceptibility test instrument t o analyze the antimicrobial susceptibility.Results We conducted the study on th e56patents who had suffered from cerebrovascular accidents compli-cated by pulmo nary infection.A total of146strains are founded in the phlegm bactierial cul-tur e.Among them,there are57.53%gram negative(G-)bacteria,31.5%gram positive (G + )bacteria and10.96%fungi,In G-bacteria,Klebsiella pneumoniae is the most frequently,founded bacteria spcci cs(21.43%),followed by Escherichia coli(16.67%),There are30.43%Staphylococcus au reus and30.43%Stapnylococcus haemolyticus in G + bacteria,The most common species in fungi is Candda albicans,In vit-ro test of antimicrobial susceptibility showed that G-bacteria are most sensitive to Imipenem/Cilas-tatin (sensitivity rate75%)and Piperaclillin/Tazobac-tam(sensitivity rate72.97%).G + bacteria are highly sensitivity to Vancomycin (sensitiviry rate92.24%).Fungi are very sensitive to5-Flucytosine and Am-photericin B.All the tested strains a re resistant to theis other antibiotics.Con clussion Based on the study,G-bacteria are the major pathagens in the tested patients and Imipenem/cila statin or Piperacillin/Tazobactam seem to b e the first choice to treat the patients had cerebrovascular accident complicat ed by pulmonary in fection.