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目的:探讨不同重症监护病房(ICU)的卒中相关性肺炎(SAP)患者的病原学分布。方法:2010-03-2012-03,对我院急诊ICU、老年ICU和综合ICU的卒中患者痰标本培养及药敏结果,进行回顾性分析。结果:142例SAP患者,124例痰液培养病原菌170株。革兰阴性菌103株(60.6%);真菌42株(24.7%);革兰阳性菌25株(14.7%)。急诊ICU细菌81株(47.6%),其中鲍曼不动杆菌20株(24.7%),MASA 18株(22.2%),大肠埃希菌10株(12.3%),肺炎克雷伯杆菌8株(9.9%);老年ICU细菌28株(16.5%),其中白假丝酵母菌10株(35.7%),光滑假丝酵母菌6株(21.4%),克柔假丝酵母菌4株(14.3%);综合ICU细菌61株(35.9%)。3组比较,老年ICU的真菌分离率最高,差异有统计学意义(P<0.05)。结论:不同ICU病房SAPP分布的病原菌菌株不同,应根据病原学特点,加强抗菌药物合理应用。
Objective: To investigate the etiological distribution of stroke-associated pneumonia (SAP) in different intensive care unit (ICU) patients. Methods: From March 2010 to March 2012, sputum samples from patients with stroke in our hospital for acute ICU, elderly ICU and ICU were retrospectively analyzed. Results: 142 SAP patients and 124 sputum culture pathogen 170 strains. Gram-negative bacteria 103 (60.6%); fungi 42 (24.7%); Gram-positive bacteria 25 (14.7%). There were 81 strains (47.6%) of emergency ICU bacteria, among which 20 Acinetobacter baumannii strains (24.7%), 18 MASA strains (22.2%), 10 Escherichia coli strains (12.3%) and 8 Klebsiella pneumoniae 9 (9.9%), 28 (16.5%) were elderly ICU bacteria, including 10 Candida albicans (35.7%), 6 Candida glabrata (21.4%), 4 Candida krusei (14.3% ); Integrated ICU bacteria 61 strains (35.9%). The fungal isolation rates of the elderly ICU were the highest among the three groups (P <0.05). Conclusion: The pathogen strains of SAPP distributed in different ICU wards are different, and the rational application of antimicrobial agents should be strengthened according to the characteristics of etiology.