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重症监护病房脑卒中相关性肺炎病原菌的分布及耐药分析
引用本文:温德良,李智博,温艺超,刘卫江,熊旭明.重症监护病房脑卒中相关性肺炎病原菌的分布及耐药分析[J].中国实用神经疾病杂志,2016(14).
作者姓名:温德良  李智博  温艺超  刘卫江  熊旭明
作者单位:广州医科大学附属第二医院重症医学科 广州 510260
摘    要:目的探讨重症监护病房(ICU)脑卒中相关性肺炎(SAP)患者病原学分布特征及耐药情况,为临床治疗提供参考。方法对我院ICU 2012-01—2015-12所有脑卒中患者的痰培养和药敏结果进行回顾性分析。结果 352例脑卒中患者,发生SAP 183例,共分离出病原菌247株,G+球菌57株(占23.1%),G-杆菌161株(65.2%),真菌29株(11.7%)。所有菌株中前5位为:鲍曼不动杆菌79株(32.0%),铜绿假单胞菌26株(10.5%),肺炎克雷伯杆菌24株(9.7%),金黄色葡萄球菌24株(9.7%),大肠埃希杆菌15株(6.1%),耐药较严重。结论 ICU中SAP发生率高,致病菌主要为G-杆菌,耐药严重,需定期监测。

关 键 词:重症监护病房  卒中相关性肺炎  病原菌  耐药性

Distribution and antibiotic resistance of pathogen isolated from patients with stroke-associated pneumonia in intensive care unit
Abstract:Objective To investigate the distribution and antibiotic resistance of clinical pathogen isolated from patients of stroke-associated pneumonia (SAP) ,then instruct clinical application of antibiotics reasonably. Methods All the patients with SAP were collected from January 2012 to December 2015 .All the specimens were analyzed for pathogen distribution and drug susceptibility. Results Of all the 352 patients ,183 cases were found having SAP. There were total 247 strains of bacteri‐a isolated ,and 161 strains(65.2% )were Gram-negative bacilli ,57 strains(23.1% )were Gram-positive cocci ,the left 29 strains (11.7% ) were fungi;the first 5 strains were Acinetobacter baumannii ,Pseudomonas aeruginosa ,Klebsiella pneumoniae , Staphylococcus aureus and Escherichia coli. Most pathogens to commonly used antibiotics were highly resistance.Conclusion The incidence rate of SAP are quite high in ICU.The major pathogen causing SAP in ICU are Gram negative ,and they were widely different degrees of resistance to many antibiotic and resistant to a range of antibiotics.Regularly monitoring the distri‐bution and drug resistance of pathogens ,and rationally using antibiotics will certainly increase the cure rate of SAP .
Keywords:Intensive care unit  Stroke associated pneumonia  Pathogen  Antibiotic resistance
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