老年急性脑卒中患者医院获得性肺感染的病原菌分布及耐药性监测

目的探讨老年急性脑卒中患者医院获得性肺感染的病原菌分布及耐药性监测情况。方法收集2011年6月至2013年6月解放军海军总医院干部保健科收治的老年急性脑卒中伴有获得性肺感染的患者132例,进行病原菌分离和药敏试验,并对药敏结果进行分析。结果分离的182株病原菌中,革兰阴性菌占59.8%,主要是铜绿假单胞菌、肺炎克雷伯菌、鲍曼不动杆菌等;革兰阳性菌占28.6%,主要为金黄色葡萄球菌;真菌占11.6%,主要是白色念珠菌。结论老年急性脑卒中伴有获得性肺感染患者的主要致病菌为革兰阴性菌,其次为革兰阳性菌。病原菌对抗菌药物存在多药耐药性,临床上应重视和加强患者的病原学检查,指导临床合理用药,降低患者的病死率。

Study on Distribution and Drug Resistance of Pathogens of Hospital Acquired Pneumonia among Elderly Patients with Acute Stroke

Objective To explore distribution and drug resistance of pathogens of hospital acquired pneumonia among elderly patients with acute stroke.Methods Clinical data of 132 cases of elderly patients with acute stroke accompanied with acquired hospital pulmonary infection admitted in Navy General Hospital of PLA from Jun.2011 to Jun.2013 were collected,pathogens of all the cases were isolated and underwent antimicrobial susceptibility test,the results of the test were analyzed.Results Among 182 strains of pathogens isolated,gram-negative bacteria occupied 59.8％,which were mainly Pseudomonas aeruginosa; Klebsiella pneumoniae and Acinetobacter baumannii,etc ; gram-positive bacteria occupied 28.6％,which were mainly Staphylococcus aureus;fungi occupied 11.6％,which were mainly Candida albicans.Conclusion The main pathogens of elderly patients with acute stroke accompanied with acquired hospital pulmonary infection are Gram-negative bacteria,followed by Gram-positives bacteria.Such pathogens have multidrug-resistance,therefore,it is necessary to focus on the etiology examination to provide guidance for rational use of antibiotics so as to reduce the mortality of the patients.