摘要
目的:探讨老年卒中相关性肺炎(SAP)患者发生多重耐药菌(MDR)感染的危险因素、MDR的分布及耐药情况,为临床SAP防治提供依据。方法:对我院神经内科2010年6月至2014年6月的老年SAP患者的临床资料进行回顾性分析,SAP发生MDR感染的危险因素进行单因素和多因素回归分析,并调查MDR病原菌的分布和耐药情况。结果:在162例SAP患者中,发生MDR的感染93例,感染率为57.4%;MDR感染与意识障碍、吞咽障碍、预防性使用抗菌药物和晚发性肺炎四个因素有密切相关,差异有统计学意义(P<0.05);93例SAP患者中分离出MDR菌147株,前5位为:鲍曼不动杆菌、肺炎克雷伯杆菌、金黄色葡萄球菌、铜绿假单胞菌、大肠埃希氏杆菌。结论:意识障碍、吞咽障碍、预防性使用抗菌药物和晚发性肺炎是SAP发生MDR感染的危险因素;MDR发生率较高,对常用抗生素呈不同程度的广泛耐药。
Objective： To discuss the risk factors, the distribution and drug resistance of multiple drug resistant （MDR） bacteria of elderly stroke-associated pneumonia （SAP） patients with multiple drug-resistant bacterial infections, so as to provide guidance for clinical treatment of SAP. Methods： A retrospective study was designed to analyze the clinical data of elderly patients with SAP from June 2010 to June 2014. Univariate analysis and multivariable regression analysis were taken for risk factors of MDR infections, and the distribution and drug resistance of MDR were investigated. Results： There were 162 patients with SAP, in which 93 cases got MDR bacteria in- fection, the rate was 57.4% ;MDR infection had close relationship with levels of consciousnesss, deglutition disorders, prophylactic antibiotics and late-onset pneumonia and the difference was significant （P〈0.05）. There were 147 MDR strains in 93 patients, the first 5 MDR strains were Acinetobacter baumannii , Klebsiella pneurnoniae , Staphylococcus aureus , Pseudomonas aerugi- nosa and Escherichia coli. Conclusion： SAP patients with MDR bacterial infections are closely re- lated to the following risk factors： levels of consciousnesss, deglutition disorders, prophylacticantibiotics and late-onset pneumonia. The rate of MDR bacterial infections is high, which shows widely different degrees of resistance to many antibiotics.
出处
《武汉大学学报（医学版）》
CAS
2015年第4期595-599,共5页
Medical Journal of Wuhan University
关键词
老年卒中相关性肺炎
多重耐药菌
危险因素
病原学
Elderly Stroke Associated Pneumonia
Multiple Drug-Resistant
Risk Factors
E- tiology
