急性脑梗死合并糖尿病患者医院获得性肺部感染的病原菌分布及耐药性
Pathogens distribution and drug resistance in patients with acute cerebral infarction complicated with diabetes and nosocomial pulmonary infection.
机构信息
Department of Emergency at Beijing Tongren Hospital of Capital Medical University, Beijing, 100176, China.
Department of General Medicine at Beijing Tongren Hospital of Capital Medical University, No. 2 of Western South Road of Yizhuang, Daxing District, Beijing, 100176, China.
出版信息
BMC Infect Dis. 2019 Jul 10;19(1):603. doi: 10.1186/s12879-019-4142-9.
BACKGROUND
This study aims to investigate the pathogen distribution and drug resistance in patients with acute cerebral infarction complicated with diabetes mellitus and nosocomial pulmonary infection.
METHODS
From August 2015 to December 2017, 172 pathogenic bacterial strains from patients with acute cerebral infarction complicated with diabetes mellitus and nosocomial pulmonary infection in our hospital were identified, and the drug sensitivity was analyzed.
RESULTS
Among these 172 strains of pathogenic bacteria, gram negative bacteria was the main cause of pulmonary infection in hospitalized patients with acute cerebral infarction, accounting for 75.6% of all pathogens. Furthermore, 80% of diabetic patients with cerebral infarction had lung infection induced by gram negative bacteria, which was significantly higher than that in non-diabetic patients (72.2%). Moreover, the drug resistance rate in the diabetic group (68.3%) was significantly higher than that in the non-diabetic group (54.3%). Gram positive bacteria accounted for 19.1% of all pathogenic bacteria. The infection rate of gram-positive bacteria in diabetic patients with cerebral infarction was 14.7%, which was lower than that in the non-diabetic group (22.6%). The drug-resistance rate was higher in the diabetic group (45.5%) than in the non-diabetic group (28.2%). Furthermore, the fungal infection rate in patients with lung infection in these two groups was 5.3 and 5.2%, respectively, and fungi presented with high sensitivity to commonly used antifungal agents.
CONCLUSION
In patients with acute cerebral infarction complicated with diabetes mellitus and nosocomial pulmonary infection, the majority of pathogens are multidrug-resistant gram negative bacilli. Pathogen culture should be conducted as soon as possible before using antibiotics, and antimicrobial agents should be reasonably used according to drug sensitivity test results.
背景
本研究旨在探讨急性脑梗死合并糖尿病并院内肺部感染患者的病原菌分布及耐药情况。
方法
选取我院 2015 年 8 月至 2017 年 12 月急性脑梗死合并糖尿病并院内肺部感染患者 172 例的病原菌进行鉴定，并分析药敏情况。
结果
172 株病原菌中，革兰阴性菌是导致住院急性脑梗死患者肺部感染的主要原因，占所有病原体的 75.6%。此外，80%的糖尿病脑梗死患者肺部感染由革兰阴性菌引起，明显高于非糖尿病患者（72.2%）。且糖尿病组（68.3%）的耐药率明显高于非糖尿病组（54.3%）。革兰阳性菌占所有病原菌的 19.1%。糖尿病脑梗死患者革兰阳性菌感染率为 14.7%，低于非糖尿病组（22.6%）。且糖尿病组耐药率（45.5%）高于非糖尿病组（28.2%）。此外，两组肺部感染真菌的感染率分别为 5.3%和 5.2%，真菌对常用抗真菌药物表现出较高的敏感性。
结论
急性脑梗死合并糖尿病并院内肺部感染患者的病原菌以多药耐药的革兰阴性杆菌为主。应用抗生素前应尽快进行病原菌培养，并根据药敏试验结果合理使用抗菌药物。
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