Yan Liu, Qing Ye, Xingyi Jin, Hongbo Qiao
Department of Neurosurgery, Jilin Center Hospital, No. 4, Nanjing Street, Chuanying District, Jinlin, 132001, China,
Cell Biochem Biophys. 2015 Mar;71(2):731-4. doi: 10.1007/s12013-014-0256-2.
Our objective is to analyze the etiology and antibiotics resistance rate of multiple drug-resistant bacteria infection in elderly patients with stroke-associated pneumonia from Neurosurgery Department, providing a reference for clinical treatment. Sputum of 372 elderly patients with stroke-associated pneumonia (SAP) from Neurosurgery Department was collected for sputum culture and drug sensitivity test, and pathogenic bacteria distribution and drug resistance rate of antibiotics were discussed. Among 372 pathogenic bacteria, there were 95 cases with Gram-positive cocci, the percentage was 15.32 %; there were 277 cases with Gram-negative bacilli, the percentage was 59.95 %; there were 54 cases with fungus, the percentage was 14.51 %; the common Gram-positive cocci included Staphylococcus aureus, Staphylococcus haemolyticus and Staphylococcus epidermidis, with percentages of 15.32 %, 2.96 % and 4.30 % respectively; the common Gram-negative bacilli included Pseudomonas aeruginosa, Escherichia coli and Klebsiella pneumoniae, with percentages of 23.92 %, 14.25 % and 9.95 % respectively; the highest drug resistance rates of Staphylococcus aureus were 100.00 % to penicillin, erythrocin and oxacillin, the highest drug resistance rate of Staphylococcus epidermidis was 87.50 % to erythrocin, the highest drug resistance rate of Staphylococcus haemolyticus was 100.00 % to penicillin and erythrocin, the lowest drug resistance rates of three Gram-negative bacilli were 0 % to teicoplanin and vancomycin; the highest drug resistance rates of Escherichia coli were 100.00 % to ceftriaxone and ticarcillin, and the lowest drug resistance rate was 11.32 % to ciprofloxacin; the highest drug resistance rate of Pseudomonas aeruginosa was 100.00 % to ceftriaxone, and the lowest drug resistance rate was 22.47 % to imipenem; the highest drug resistance rate of Klebsiella pneumoniae was 81.08 % to aztreonam, and the lowest drug resistance rate was 0.00 % to imipenem. Stroke-associated pneumonia is common clinically in elderly patients from Neurology Department, the early-stage and rational use of antibiotics should be applied according to the etiologic distribution and drug resistance characteristics. Meanwhile, prevention measures should be applied.
我们的目的是分析神经外科老年卒中相关性肺炎患者多重耐药菌感染的病因及抗生素耐药率,为临床治疗提供参考。收集神经外科372例老年卒中相关性肺炎(SAP)患者的痰液进行痰培养及药敏试验,探讨病原菌分布及抗生素耐药率。372株病原菌中,革兰阳性球菌95例,占15.32%;革兰阴性杆菌277例,占59.95%;真菌54例,占14.51%;常见革兰阳性球菌包括金黄色葡萄球菌、溶血葡萄球菌和表皮葡萄球菌,分别占15.32%、2.96%和4.30%;常见革兰阴性杆菌包括铜绿假单胞菌、大肠埃希菌和肺炎克雷伯菌,分别占23.92%、14.25%和9.95%;金黄色葡萄球菌对青霉素、红霉素和苯唑西林的耐药率最高,均为100.00%,表皮葡萄球菌对红霉素的耐药率最高,为87.50%,溶血葡萄球菌对青霉素和红霉素的耐药率最高,均为100.00%,3种革兰阴性杆菌对替考拉宁和万古霉素的耐药率最低,均为0%;大肠埃希菌对头孢曲松和替卡西林的耐药率最高,均为100.00%,对环丙沙星的耐药率最低,为11.32%;铜绿假单胞菌对头孢曲松的耐药率最高,为100.00%,对亚胺培南的耐药率最低,为22.47%;肺炎克雷伯菌对氨曲南的耐药率最高,为81.08%,对亚胺培南的耐药率最低,为0.00%。卒中相关性肺炎在神经科老年患者中临床常见,应根据病因分布及耐药特点尽早合理应用抗生素,同时应采取预防措施。