中国医学前沿杂志（电子版）2018，Vol.10Issue(4)：19-23,5.DOI:10.12037/YXQY.2018.04-04
脑卒中呼吸机相关性肺炎多重耐药感染的危险因素及病原学分析
Risk factors and pathogenicity analysis of multi-drug resistant bacterial infection in ventilator-associated pneumonia
摘要
Abstract
Objective To analyze the risk factors and etiological characteristics of multi-drug resistance in ventilator-associated pneumonia in patients with stroke-associated pneumonia. Method The clinical data of 82 stroke patients who underwent mechanical ventilation in our department from January 2016 to April 2017 were retrospectively analyzed, including age, gender, associated underlying diseases, and invasive procedures. Relevant factors were given to univariate and multivariate Logistic regression analysis, and patient-related specimens were collected using a fully automated bacterial culture analyzer. Result In 82 stroke patients treated with mechanical ventilation, 39 patients developed ventilator associated pneumonia, with an incidence rate of 47.56%. A total of 67 strains of multi-drug resistant bacteria were detected, Gram-negative bacteria mainly consisted Acinetobacter baumannii and Pseudomonas aeruginosa, and Gram-positive bacteria mainly consisted Staphylococcus. Commonly used antibiotics had different levels of drug resistance, including Pseudomonas aeruginosa and Acinetobacter baumannii to Ampicillin, Aampicillin/Sulbactam, Cefoperazone. The drug resistance rate were higher. Gram-positive bacteria golden yellow grape balls and Staphylococcus epidermidis resistant rates to Cefazolin, Penicillin and Azithromycin were as high as 100.0%, but their resistance to Vancomycin, Teicoplanin and Linezolid has no drug resistance. Age＞60 years old, antibiotic use≥2 kinds, presence of consciousness disorder, and serum albumin level＜30 g/L were the independent risk factors for the occurrence of multiple resistance of ventilator associated pneumonia in stroke patients (P＜0.05). Conclusion There are relatively more risk factors for multi-drug resistant infections in stroke-associated pneumonia patients. Therefore, precautions must be taken based on their risk factors, and clinically based on the patient's pathogens. Characteristics and drug susceptibility test results enhance the rational use of antibiotics, avoid the emergence of drug-resistant strains, and improve clinical efficacy.关键词
脑卒中/呼吸机相关性肺炎/多重耐药/危险因素/病原学Key words
Stroke/Ventilator-associated pneumonia/Multiple drug resistance/Risk factors/Etiology引用本文复制引用
段娜,韩芳,杨玉秀,陈开琴..脑卒中呼吸机相关性肺炎多重耐药感染的危险因素及病原学分析[J].中国医学前沿杂志（电子版）,2018,10(4):19-23,5.基金项目
湖北省科技计划项目(1600623996) （1600623996）
