老年脑卒中住院患者并发尿路感染的临床分析及诊治研究

目的 探讨老年脑卒中住院患者并发尿路感染的危险因素及病原菌、耐药情况.方法 随机选取济南市第八人民医院2010年12月至2013年1月收治的368例老年脑卒中患者为研究对象,对其中的42例伴有尿路感染的患者进行危险因素及病原菌、耐药情况进行分析.结果 Logistic回归分析结果显示,老年脑卒中住院患者尿路感染的危险因素有高龄、留置导尿管、糖尿病、低蛋白血症、出血性脑卒中（P＜0.05）.病原菌中以革兰阴性杆菌为主,占51%;在革兰阴性菌中,仅对亚胺培南、头孢噻肟、阿米卡星敏感性较高;在革兰阳性菌中,对呋喃妥因、利奈唑胺、万古霉素的敏感性高;而在真菌敏感性中,对所有抗真菌药物的敏感性均较高.结论 老年脑卒中住院患者尿路感染的危险因素较多,主要与病情有关,且应选择敏感的抗生素对症治疗.

Clinical Analysis and Research of Diagnosis and Treatment for Elderly Hospitalized Patients with Cerebral Apoplexy Complicated Urinary Tract Infection

Objective To investigate risk factors, pathogens, and drug resistance of urinary tract infec- tions in elderly hospitalized patients with stroke. Methods Randomly selected from the Eighth People＇s Hospital of Jinan City during December 2010 and January 2013,36g cases of elderly stroke patients were included in this study,among which the risk factors, pathogens and resistance drugs of 42 cases associated with urinary lract infections,were analyzed. Results Logistic regression analysis showed：the risk factors for urinary tract infeetion in elderly hospitalized patients with stroke included advanced age,indwelling catheters, diabetes, hypoalbuminemia, and hemorrhagic brain stroke （ P 〈 0.05 ） ; Gram-negative bacilli, accounted for 51%;in Gram-negative bacteria,only tbr imipenem, eefotaxime, amikacin sensitive than high, which had high sensitivity only to imipenem,cefotaxime,and amikacin,while the Gram-positive bacteria had higher sensitivity to nitrofurantoin,linezolid,vancomycin;fungus had higher sensitivity to all antifungals. Conclusion There are plenty of risk factors for urinary tract infections of elderly hospitalized patients with stroke, among which the disease eondition is a major factor,and sensitive antibiotics should be applied liar the symptoms treatment.