重症与非重症急性期脑卒中相关性肺炎病原学临床研究

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Abstract Objective To investigate whether the distribution and drug resistance of pathogenic bacteria of acute apoplexy associated pneumonia in the neurointensive care unit (NICU) are similar to those of general wards in order to guide the use of antibiotics in clinic.Methods A retrospective study was conducted to analyze and compare the composition of sputum-cultured pathogenic bacteria and drug sensitivity test results of acute apoplexy associated pneumonia (SAP) patients admitted to NICU and general wards of Jiangsu Provincial Corps Hospital between October 2015 and December 2019.Results 1.Comparison of sputum-cultured pathogenic bacteria:Gram-negative bacilli were the dominant pathogenic bacteria in the NICU group and the general ward group,but the proportion of gram-negative bacilli in the NICU group was significantly higher than that of the general ward group,so was the proportion of multi-drug resistant bacteria in the NICU group.Fungal infections occurred only in the NICU group.There was statistically significant difference between the two groups (P<0.05).2.Sputum culture susceptibility results:(1) In the NTCU group,there were more multiple drug resistance bacteria in pseudomonas aeruginosa,Klebsiella pneumoniae,and e.coli bacterium (resistance rate ranged from 60.0% to 100.0%).There were some cases of of mixed infections and high sensitivity to meroppenem and imipenem (sensitivity rate ranged from 59.77% to 90.14%) and to tiagocycline of gram-negative bacteria except for pseudomonas aeruginosa (83.7%-100.0%).(2) Bacteria from the NICU group were generally more sensitive than those from the general ward group.(3) The gram-negative bacilli detected in the general ward group were more resistant to conventional antibiotics (drug resistance rate >75%),somewhat sensitive to piperacillin tazobactam and cefatadine (sensitivity rate 60.0%-70.0%),and highly sensitive to levofloxacin,amikacin,meropenem,imipenem and tigacycline (sensitivity rate >75%).(4) The proportion of gram-positive bacteria detected in the two groups was significantly lower than that of gram-negative bacteria,among which the drug resistance rate of Staphylococcus aureus to penicillin,rhodoxin and cefazolin reached 100%,while the drug resistance rate of tiagocycline was low.No resistant strains to vancomycin,linezolid or tekoranin were found yet.Conclusions The pathogenic bacteria of SAP patients in the NICU group are mostly gram-negative bacilli,such as pseudomonas aeruginosa,Klebsiella pneumoniae,and Escherichia coli,thus increasing the chance of multi-drug resistance and mixed infection.Imipenem,amikacin,tiagocycline and other drugs should be considered the main drugs to be used,but they are likely to be complicated with fungal double infections.In general wards,pathogenic bacteria are still dominated by ceratadine negative bacilli.Cefatadine,piperacillin tazobactam,amikacin,levofloxacin and other antibiotics should be considered first.

Key words： acute stroke stroke associated pneumonia sputum culture pathogenic bacteria drug resistance

Received: 10 April 2020

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	ZHANG Hui
	CHEN Min
	LIU Xuhong

Cite this article:

ZHANG Hui,CHEN Min,LIU Xuhong. Etiology of pneumonia associated with severe and non-severe acute stroke[J]. Med. J. Chin. Peop. Armed Poli. Forc., 2020, 31(11): 935-939.

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http://journal08.magtechjournal.com/Jwk_wjyx/EN/ OR http://journal08.magtechjournal.com/Jwk_wjyx/EN/Y2020/V31/I11/935

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