摘要
目的探讨脑血管疾病患者合并肺部感染的病原菌分布,并对其临床意义提出分析,为其临床防治提供依据。方法调查医院脑血管疾病合并肺部感染的住院患者120例,详细记录所有患者的病史及相关信息,并进行痰培养及药敏分析,分析病原菌与疾病的相关性。结果 120例患者共分离检出病原菌144株,其中革兰阴性菌78株占54.2%,以肺炎克雷伯菌最多占15.3%,革兰阳性菌46株占31.9%,以金黄色葡萄球菌最多占15.3%,真菌20株占13.9%,均为白色假丝酵母菌;所有发生感染的患者中,局部定植71例、局部感染33例、菌血症16例;肺部感染革兰阴性菌对头孢哌酮/舒巴坦敏感率最高为84.6%,其次亚胺培南敏感率为78.2%;革兰阳性菌对利奈唑胺敏感率最高为97.8%,其次万古霉素敏感率为87.0%;真菌对氟康唑最敏感,敏感率为90.0%,其次为伏立康唑敏感率为80.0%。结论脑血管疾病患者合并肺部感染的病原菌以革兰阴性菌最多,其对头孢哌酮/舒巴坦最敏感,革兰阳性菌对利奈唑胺最敏感,真菌感染对氟康唑最敏感;在临床治疗过程中,在药敏试验之前,可以根据经验给予患者相应的治疗措施。
OBJECTIVE To explore the distribution of pathogens causing pulmonary infections in the patients complicated with cerebrovascular diseases and explore the clinical significance so as to provide basis for the clinical prevention and treatment. METHODS A total of 120 cases of hospitalized patients complicated with cerebrovascu- lar diseases and pulmonary infections were investigated, the medical history and the related information of all the patients were recorded in detail, the sputum culture and the drug susceptibility testing were performed, and the correlation between the pathogens and the diseases was analyzed. RESULTS Of totally 144 strains of pathogens isolated from the 120 patients, there were 78 （54.2%） strains of gram-negative bacteria, among which the Kleb- siella pneumoniae was dominant （15. 3%）, there were 46 （31. 9%） strains of gram-positive bacteria, among which the Staphylococcus aureus was the predominant species （15.3%）, and there were 20 （13.9%） strains of fungi, all of which were Candida albicans （13.9 %）. Of all the patients with infections, there were 71 cases with local bacterial colonization, 33 cases with local infections, and 16 cases with bacteremia. The drug susceptibility rate of the gram-negative bacteria causing the pulmonary infections was the highest to cefoperazone/sulbaetam （84. 6%）, followed by imipenem （78.2%） ; the drug susceptibility rate of the gram-positive bacteria causing the pulmonary infections was the highest to linezolid （97.8%）, followed by vancomycin （87.0%）% the fungi were most sensitive to fluconazole with the drug susceptibility rate of 90. 0%, followed by voriconazole （80. 0%）. CONCLUSION The gram-negative bacteria are the dominant among the pathogens causing pulmonary infections in the patients complicated with the cerebrovascular diseases, the strains are most sensitive to cefoperazone/ sulbactam, the gram-positive bacteria are most sensitive to linezolid, and the fungi are most sensitive to fluconazole. It is necessary to perform the appropriate treatment on the basis of the drug susceptibility testing.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2013年第12期3026-3028,共3页
Chinese Journal of Nosocomiology
关键词
脑血管疾病
肺部感染
病原菌
Cerebrovascular disease
Pulmonary infection
Pathogen
