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目的探讨老年脑卒中患者肺部感染病原菌类型、耐药性及肺部感染相关因素。方法回顾性分析2011年3月-2014年12月286例老年脑卒中患者临床资料,分析感染病原菌类型、主要病原菌耐药性及肺部感染危险因素。结果286例老年脑卒中患者肺部感染率为22.73%,共检出病原菌86株,其中革兰阴性菌、革兰阳性菌、真菌分别为52株、28株、6株,各占60.47%、32.56%、6.98%。除铜绿假单胞菌对美罗培南、亚胺培南耐药率为0,金黄色葡萄球菌对万古霉素、替考拉宁耐药率为0,其他病原菌显示多药耐药;Logistic回归分析发现住院时间、意识障碍、合并糖尿病、机械通气等因素是发生肺部感染的独立危险因素,差异均具有统计学意义(P<0.05)。结论老年脑卒中患者医院发生肺部感染相关危险因素较多,应采取对应措施控制危险因素,有针对性选择抗菌药物。
Objective To investigate the pathogenic bacteria types, drug resistance and related factors of lung infection in elderly patients with stroke. Methods The clinical data of 286 elderly stroke patients from March 2011 to December 2014 were retrospectively analyzed. The types of pathogens, drug resistance of major pathogens and risk factors of pulmonary infection were analyzed. Results The lung infection rate in 286 senile stroke patients was 22.73%. 86 pathogenic bacteria were detected, of which, Gram-negative bacteria, Gram-positive bacteria and fungi were 52, 28 and 6, accounting for 60.47% 32.56%, 6.98%. In addition to the Pseudomonas aeruginosa on Meropenem, imipenem resistance rate of 0, Staphylococcus aureus vancomycin, teicoplanin resistance rate of 0, other pathogens showed multidrug resistance; Logistic regression analysis Found that hospitalization time, disturbance of consciousness, diabetes mellitus, mechanical ventilation and other factors are independent risk factors for pulmonary infection, the difference was statistically significant (P <0.05). Conclusion There are many risk factors associated with pulmonary infection in elderly patients with stroke. Corresponding measures should be taken to control risk factors and targeted antibiotics.