摘要
目的分析缺血性脑卒中患者并发重症肺炎的病原菌与影响因素。方法回顾性分析2014年1月-2018年1月于医院治疗的缺血性脑卒中患者415例的临床资料,其中并发肺炎165例;根据肺炎的程度将肺炎患者分为一般肺炎组134例和重症肺炎组31例,分析肺炎患者的病原菌特点,分析患者性别、年龄、卒中部位、意识障碍情况及侵入性操作等临床资料,归纳缺血性脑卒中患者并发重症肺炎的影响因素。结果 2014年1月-2018年1月医院缺血性脑卒中患者重症肺炎的发生率为7.47%(31/415)。31例患者共培养分离病原菌29株,其中革兰阴性菌23株占79.31%,革兰阳性菌6株占20.69%,以铜绿假单胞菌和鲍氏不动杆菌为主;主要病原菌对头孢唑林、头孢曲松、环丙沙星、左氧氟沙星和庆大霉素的耐药率均>50%,对万古霉素、头孢呋辛、美罗培南和亚胺培南较敏感。意识障碍、COPD、糖尿病史是缺血性脑卒中患者并发重症肺炎的影响因素(P<0.05)。结论重症肺炎是缺血性脑卒中患者的严重并发症,以革兰阴性菌感染为主,其发生的影响因素较多,应采取针对性措施控制其发生。
OBJECTIVE To analyze pathogens and influencing factors of severe pneumonia in patients with ischemic stroke.METHODS The clinical data of 415 patients with ischemic stroke treated in the hospital from Jan.2014 to Jan.2018 were retrospectively analyzed,among which 165 patients were complicated with pneumonia.According to the degree of pneumonia,the 165 pneumonia patients were divided into the general pneumonia group(134)and the severe pneumonia group(31).The characteristics of pathogens in the patients with pneumonia were analyzed,together with the clinical data such as genders,age,stroke sites,consciousness disorder and invasive operation,and the influencing factors of severe pneumonia in patients with ischemic stroke were summarized.RESULTS In Jan.2014 to Jan.2018,the incidence of severe pneumonia in ischemic stroke patients was 7.47%(31/165).A total of 29 strains of pathogenic bacteria were isolated from the 31 patients,including 23 strains of Gram-negative bacteria(79.31%)and 6 strains of Gram-positive bacteria(20.69%),mainly Pseudomonas aeruginosa and Acinetobacter baumannii.The main pathogens all showed resistance of higher than 50%to cefazolin,ceftriaxone,ciprofloxacin,levofloxacin and gentamicin,and were relatively sensitive to vancomycin,cefuroxime,meropenem and imipenem.Consciousness disorder,COPD and diabetes history were the influencing factors of severe pneumonia in patients with ischemic stroke(P<0.001).CONCLUSION Severe pneumonia is a serious complication in patients with ischemic stroke.Gram-negative bacterial infection is the main cause of severe pneumonia.There are many influencing factors.Targeted measures should be taken to control the occurrence of severe pneumonia.
作者
梁章荣
李旷怡
张英俭
梁伟伟
姚红
蔡海荣
梁佩玲
LIANG Zhang-rong;LI Kuang-yi;ZHANG Ying-jian;LIANG Wei-wei;YAO Hong;CAI Hai-rong;LIANG Pei-ling(FoShan Hospital of TCM,Foshan,Guangdong528000,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2019年第11期1656-1659,共4页
Chinese Journal of Nosocomiology
基金
广东省科技计划基金资助项目(2016B031601055)
关键词
缺血性脑卒中
重症肺炎
病原菌
影响因素
Ischemic stroke
Severe pneumonia
Pathogens
Influencing factors
