摘要
目的探究医院2014年度急诊科脑梗死患者感染发生率、感染致病菌及耐药性,为临床提供指导意见。方法回顾性收集2014年1-12月急诊科救治的脑梗死患者257例,按规定采集患者尿液、粪便、血液、痰液分泌物标本并按照相关方法进行感染致病菌检查及药敏试验。结果 2014年急诊脑梗死患者共257例,其中发生感染患者为34例,感染率为13.23%,以呼吸道感染最多见,为19例,占55.89%;急诊脑梗死感染病例中,细菌培养34例,共培养出51株病原菌,其中革兰阴性菌30株,占58.82%,革兰阳性菌17株,占33.33%,真菌4株,占7.84%;真菌感染敏感性酮康唑或氟康唑最高,革兰氏阳性菌和革兰氏阴性菌以左氧氟沙星以及头孢噻肟敏感性最高。结论医院急诊科脑梗死患者感染以呼吸道细菌感染为主,细茵感染首选头孢噻肟或左氧氟沙星,真菌性感染治疗首选酮康唑或氟康唑。
OBJECTIVE To explore the incidence of infections in patients with acute cerebral infarction of emergency department in 2014 and observe the distribution and drug resistance of pathogens causing the infections so as to provide guidance for clinical treatment .METHODS A total of 257 patients with cerebral infarction who were treated in the department of emergency from Jan 2014 to Dec 2014 were retrospectively enrolled in the study .The urine , stool ,blood ,sputum ,and secretions specimens were collected from the patients according to the rules ,the patho‐genic bacteria causing the infections were detected ,and the drug susceptibility testing was performed .RESULTS Of totally 257 patients with acute cerebral infarction who were treated in the emergency department in 2014 ,34 had the infection ,with the infection rate 13 .23% ,of whom 19 （55 .89% ） had respiratory tract infection .The bacteri‐al culture was conducted for 34 patients with acute cerebral infarction ,and totally 51 strains of pathogens were iso‐lated ,including 30 （58 .82% ） strains of gram‐negative bacteria ,17 （33 .33% ） strains of gram‐positive bacteria , and 4 （7 .84% ） strains of fungi .The fungi causing the infection were the most susceptible to ketoconazole or flu‐conazole;the gram‐positive bacteria and the gram‐negative bacteria were the most susceptible to levofloxacin and cefotaxime .CONCLUSION The patients with respiratory tract bacterial infection are dominant among the acute cer‐ebral infarction patients with the infection .The cefotaxime or levofloxacin should be the preferred choice for treat‐ment of the bacterial infection ;the ketoconazole or fluconazole should be the preferred choice for the treatment of the fungal infection .
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2016年第22期5144-5146,共3页
Chinese Journal of Nosocomiology
基金
基金项目:湖北省卫生厅(2014110602)
关键词
急诊科
急性脑梗死
感染
Department of emergency
Acute cerebral infarction
Infection
