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高血压自发性脑室出血脑室外引流术后肺部感染的致病菌分布及耐药性分析

  • 邹文卫,蒋敏,赵颖,赵连东,郭慧琴,杨光,赵志强, 文成才

* 通信作者: 邹文卫, 单位:江苏省淮安市第二人民医院 223002

摘要


目的 探究高血压自发性脑室出血脑室外引流术后肺部感染发生率、感染致病菌分布及耐药性状况,为临床抗菌药物合理使用提供指导。

方法 研究对象病例回顾性选取来我院住院治疗的高血压自发性脑室出血脑室外引流术患者89例,通过我院伦理委员会审核通过,经患者或家属同意,按规定采集患者痰分泌物标本并按照相关

方法进行感染致病菌检查及药敏试验。

结果 高血压自发性脑室出血脑室外引流术患者发生肺部感染21例(23.60%),肺部感染与非肺部感染患者在合并肺部基础疾病、出血量及死亡率上存在差异(P<0.05);高血压自发性脑室出血脑室外引流术合并肺部感染患者21例痰培养阳性18例(85.71%),培养出47株病原菌;铜绿假单胞菌对氨苄西林、头孢曲松的耐药性最高,为81.82%,对左氧氟沙星耐药性最低,为18.18%;大肠埃希菌对氨苄西林、环丙沙星、左氧氟沙星耐药性最高,为75%;对头孢他啶、哌拉西林耐药性最低,为37.5%;金黄色葡萄球菌对青霉素G、阿莫西林/棒酸耐药性最高,为77.78%,而对万古霉素高度敏感;真菌感染敏感性酮康唑或氟康唑最高。

结论 高血压自发性脑室出血脑室外引流术肺部感染患者以革兰阴性菌为主,及时监测病原体、合理选用抗生素有利于院内肺部感染的防治。

关键词:高血压;自发性脑室出血;脑室外引流术;肺部感染;耐药性

ABSTRACT


Objective To explore the incidence, distribution and drug resistance of pulmonary infection after external ventricular drainage in patients with spontaneous ventricular hemorrhage, and provide guidance for rational use of antibiotics.

Methods: the subjects of this study were retrospectively selected hospitalized in our hospital spontaneously hypertensive intraventricular hemorrhage ventricle external drainage in patients with 89 cases, by our hospital ethics committee review, with the consent of the patients or their families, according to the provisions of the collection sputum secretion samples and in accordance with the relevant methods were infected by pathogen detection and drug sensitivity test.

Results ventricular drainage hypertensive spontaneous intraventricular hemorrhage 21 cases pulmonary infection patients (23.60%), pulmonary infection and pulmonary infection in patients with non complicated pulmonary diseases, bleeding and mortality differences (P < 0.05); spontaneous intraventricular hemorrhage hypertension ventricle external drainage in 21 cases 18 cases of positive sputum of patients with pulmonary infection (85.71%), cultured 47 strains of pathogenic bacteria; drug resistance of Pseudomonas aeruginosa to ampicillin, ceftriaxone was 81.82%, the highest, lowest resistance to levofloxacin, 18.18%; Escherichia coli to ampicillin, ciprofloxacin, levofloxacin resistance was 75%; the highest of ceftazidime and piperacillin resistance minimum. 37.5%; Staphylococcus aureus to penicillin G, amoxicillin / clavulanic acid resistance was 77.78%, the highest, and highly sensitive to vancomycin. The sensitivity of ketoconazole or fluconazole; fungal infection is highest.

Conclusion   the main pathogens of the patients with primary hypertension and the external drainage of ventricle drainage in the treatment of the patients with pulmonary infection were mainly gram negative bacteria. Timely detection of pathogens and rational use of antibiotics is beneficial to the prevention and treatment of pulmonary infection in hospital.

Key words: hypertension; spontaneous ventricular hemorrhage; external ventricular drainage; pulmonary infection; drug resistance

引用本文 / How to Cite This Article

邹文卫,蒋敏,赵颖,赵连东,郭慧琴,杨光,赵志强, 文成才.高血压自发性脑室出血脑室外引流术后肺部感染的致病菌分布及耐药性分析[J]. 国际精神病学杂志, , (): -

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