缺血性脑卒中患者介入治疗后并发相关性肺炎的病原菌分布及药敏分析

目的:探讨缺血性脑卒中患者介入治疗后并发相关性肺炎的病原菌分布情况及其耐药性,为临床合理选择抗菌药物进行抗感染治疗提供参考。方法:选择2016年5月-2018年6月大连医科大学附属大连市中心医院神经内一科收治的182例缺血性脑卒中介入治疗后并发相关性肺炎患者,对患者痰标本进行细菌培养和鉴定,并对培养阳性的病原菌进行药物敏感性试验。结果:182例患者共送检痰标本并进行细菌培养276次,其中阳性检出199次,阳性检出率为72.10%,检出病原菌215株,革兰阴性杆菌153株,占71.16%,其中鲍氏不动杆菌是主要病原菌,占24.19%,其次为肺炎克雷伯菌,占20.93%;革兰阳性球菌62株,占28.84%,其中金黄色葡萄球菌为主要的病原菌,占11.16%,其次为溶血葡萄球菌,占7.91%。革兰阴性杆菌和革兰阳性球菌中的主要病原菌对抗菌药物的耐药性较严重,且存在多药耐药性的现象。结论:缺血性脑卒中患者介入治疗后并发相关性肺炎的病原菌以革兰阴性杆菌为主,且存在多药耐药率高的现象,临床应合理选取抗菌药物进行治疗。

Distribution and Drug Resistance of Pathogenic Bacteria Causing Associated Pneumonia in Patients with Cerebral Ischemic Stroke after Interventional Therapy

ABSTRACT Objective: To explore the distribution and drug resistance of pathogenic bacteria causing associated pneumonia in patients with cerebral ischemic stroke after interventional therapy, so as to provide reference for rational selection of antimicrobial drugs in anti-infective treatment in clinic. Methods: 182 patients with cerebral ischemic stroke complicated associated pneumonia after interventional therapy in First Department of Neurology in Dalian Central Hospital Affiliated to Dalian Medical University from May 2016 June 2018 were selected. Bacterial culture and identification of sputum specimens were carried out, and drug sensitivity tests were carried out to culture positive pathogens. Results: A total of 276 cases of bacteria culture and sputum specimens were performed from 182 patients. The positive rate was 199 times, and the positive detection rate was 72.10%. 215 strains of pathogenic bacteria were detected, there were 153 strains of gram-negative bacteria, accounting for 71.16%, in which acinetobacter baumannii was the main pathogenic bacteria, accounting for 24.19%, follorws by klebsiella pneumoniae, accounting for 20.93%. There were 62 strains of gram-positive bacteria, accounting for 28.84%, in which staphylococcus aureus was the main pathogenic bacteria, accounting for 11.16%,followed by staphylococcus haemolyticus, accounting for 7.91%. The main pathogenic bacteria of gram-negative bacteria and gram-positive bacteria are more resistant to antibacterials, and there is a phenomenon of multidrug resistance. Conclusion: The gram-negative bacteria are the main pathogenic bacteria causing associated pneumonia in patients with cerebral ischemic stroke after interventional therapy, and the pathogenic bacteria has a phenomenon of multiple drug resistance, so it is important to select the antibacterials rationally for the clinical treatment.