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目的探讨癫痫患者并发感染的病原菌分布、耐药性及其对血清热休克蛋白与胶质纤维酸性蛋白的影响。方法选取2012年1月-2016年12月医院收治的难治性癫痫持续状态合并感染的246例患者为观察组,另外选取同期收治的癫痫未发生感染患者202例为对照组,采集感染部位标本进行病原菌鉴定和药敏试验;采集空腹血检测热休克蛋白(HSP)和胶质纤维酸性蛋白(GFAP)。结果观察组患者中以呼吸道感染为主,共193例占78.46%;共检出230株病原菌,以革兰阴性菌为主,共137株占59.57%;鲍氏不动杆菌和铜绿假单胞菌均对左氧氟沙星、氯霉素、米诺环素、阿米卡星、氨曲南、头孢哌酮/舒巴坦耐药率较低,均<10.00%;观察组血清HSP-70、HSP-90和GFAP水平显著高于对照组(P<0.05)。结论呼吸道感染是癫痫患者最易发生的医院感染类型,其中革兰阴性菌是主要病原菌;感染可导致癫痫患者血清HSP和GFAP表达水平上升。
Objective To investigate the distribution of pathogens, the drug resistance and the effects on serum heat shock proteins and glial fibrillary acidic protein in patients with epilepsy. Methods A total of 246 patients with refractory status epilepticus co-infection treated in our hospital from January 2012 to December 2016 were selected as the observation group. Another 202 patients without epilepsy were selected as the control group, Pathogen identification and drug sensitivity test were carried out. Fasting blood was collected to detect heat shock protein (HSP) and glial fibrillary acidic protein (GFAP). Results In the observation group, respiratory infection was the main cause, with a total of 193 cases accounting for 78.46%. A total of 230 strains of pathogens were found, of which Gram-negative bacteria was the main type, with 137 strains accounting for 59.57%. Acinetobacter baumannii and Pseudomonas aeruginosa The antibacterial activity of levofloxacin, chloramphenicol, minocycline, amikacin, aztreonam and cefoperazone / sulbactam was lower than 10.00% 90 and GFAP levels were significantly higher than the control group (P <0.05). Conclusions Respiratory tract infection is the most common type of nosocomial infection in patients with epilepsy. Among them, Gram-negative bacteria are the main pathogens. Infection can lead to the increase of serum HSP and GFAP levels in epileptic patients.