Yang Weijian, Yao Haijun, Xi Caihua, Ye Xiangru, Chen Qifang, Zhang Jun, Yu Jian, Hu Jin
Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai 200040, China.
National Center for Neurological Disorders, Shanghai 200040, China.
Microorganisms. 2023 Aug 2;11(8):1992. doi: 10.3390/microorganisms11081992.
Patients with brain injuries are at a heightened susceptibility to bacterial pneumonia, and the timely initiation of empiric antibiotic treatment has been shown to substantially reduce mortality rates. Nevertheless, there is a need for knowledge regarding the resistance and prevalence of pulmonary bacterial infections in this patient population. To address this gap, a retrospective study was conducted at a neurosurgical emergency center, focusing on patients with brain injuries. Among the entire patient population, a total of 739 individuals (18.23%) were identified as having bacterial pneumonia, consisting of 1489 strains of Gram-negative bacteria and 205 strains of Gram-positive bacteria. The resistance of to imipenem exhibited a significant increase, rising from 21.74% in 2009 to 96.67% in 2018, and subsequently reaching 48.47% in 2021. displayed resistance rates exceeding 80.0% against multiple antibiotics. The resistance profile of was relatively low. The proportion of reached its peak at 18.70% in 2016, but experienced a decline to 7.83% in 2021. The abundance of Gram-negative bacteria exceeded that of Gram-positive bacteria by a factor of 5.96. , , and are prominent pathogens characterized by limited antibiotic choices and scarce treatment alternatives for the isolated strains.
脑损伤患者对细菌性肺炎的易感性较高，事实证明，及时开始经验性抗生素治疗可大幅降低死亡率。然而，对于该患者群体中肺部细菌感染的耐药性和流行情况仍需了解。为填补这一空白，在一家神经外科急诊中心开展了一项回顾性研究，重点关注脑损伤患者。在整个患者群体中，共有739人（占18.23%）被确定患有细菌性肺炎，其中包括1489株革兰氏阴性菌和205株革兰氏阳性菌。对亚胺培南的耐药性显著增加，从2009年的21.74%升至2018年的96.67%，随后在2021年达到48.47%。对多种抗生素的耐药率超过80.0%。 的耐药情况相对较低。 在2016年达到峰值，为18.70%，但在2021年降至7.83%。革兰氏阴性菌的数量比革兰氏阳性菌多5.96倍。 、 和 是主要病原体，其特点是分离菌株的抗生素选择有限且治疗方案稀缺。
