Wattoo Muhammad Adnan, Tabassum Muhammad, Bhutta Kiran R, Rafi Zainab, Kaneez Mehwish, Razzaq Mustafa Tauseef, Rizwan Rafay, Sarwar Zoya, Sajid Muhammad Usama, Bhutta Fatima Rafique
Neurology, Sialkot Medical College, Sialkot, PAK.
Internal Medicine, Islam Medical and Dental College, Sialkot, PAK.
Cureus. 2021 May 24;13(5):e15214. doi: 10.7759/cureus.15214.
Background Hospital-acquired pneumonia (HAP) is a leading cause of morbidity and mortality in patients with ischemic stroke. Our study aims to explore the clinical and microbiological aspects (culture and sensitivity) of stroke patients with a confirmed diagnosis of HAP. Methodology This retrospective cross-sectional study included a total of 232 patients with a confirmed diagnosis of HAP following ischemic stroke. HAP was diagnosed based on the timing of onset of symptoms and chest X-ray. Patients were evaluated for their demographic details and a myriad of clinical parameters including dysphagia, mechanical ventilation, mortality, spontaneous pneumothorax, and Glasgow coma scale (GCS) score. The frequencies of different microorganisms isolated from the tracheal secretions were reported. Thereafter, the percentages of resistant isolates against a plethora of antimicrobial agents were tabulated. Results Out of 232 patients, 110 were males and 122 were females with a mean age of 58.79 ± 8.62 years. Dysphagia and mechanical ventilation were present in 66.4% and 72%, respectively. The mortality rate was 30.6%. was the most frequently isolated organism (28.9%), followed by (24.5%), and (23.3%). The antimicrobial resistance patterns of most of the isolates against different antibiotics were alarmingly high. Conclusions Dysphagia and mechanical ventilation are frequently present in patients of ischemic stroke with associated HAP. The antimicrobial resistance patterns of the isolated organisms are a cause of major concern. This necessitates the need for proper sanitation and the careful use of antibiotics.
背景 医院获得性肺炎(HAP)是缺血性脑卒中患者发病和死亡的主要原因。我们的研究旨在探讨确诊为HAP的脑卒中患者的临床和微生物学方面(培养和药敏)。方法 这项回顾性横断面研究共纳入232例确诊为缺血性脑卒中后发生HAP的患者。根据症状出现时间和胸部X线诊断HAP。评估患者的人口统计学细节以及包括吞咽困难、机械通气、死亡率、自发性气胸和格拉斯哥昏迷量表(GCS)评分在内的众多临床参数。报告从气管分泌物中分离出的不同微生物的频率。此后,将对多种抗菌药物耐药的分离株百分比制成表格。结果 在232例患者中,男性110例,女性122例,平均年龄58.79±8.62岁。吞咽困难和机械通气分别占66.4%和72%。死亡率为30.6%。 是最常分离出的病原体(28.9%),其次是 (24.5%)和 (23.3%)。大多数分离株对不同抗生素的耐药模式高得惊人。结论 缺血性脑卒中合并HAP的患者经常出现吞咽困难和机械通气。分离出的病原体的耐药模式是一个主要关注点。这就需要进行适当的卫生处理并谨慎使用抗生素。