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目的分析急性脑血管疾病患者医院感染的病原学特点及相关因素,为预防医院感染提供依据。方法回顾性分析医院收治的200例急性脑血管疾病患者的临床资料,统计分析患者的感染率、感染部位、病原菌分布及其耐药性。结果入选的200例急性脑血管疾病患者中发生医院感染32例,感染率为16.00%,男性18例,感染率为16.07%;女性14例,感染率为15.91%,差异无统计学意义;感染部位以呼吸道为主,46.88%,其次为泌尿道、皮肤软组织、胃肠道和五官,分别占18.75%、15.62%、12.50%和6.25%;采集的42份标本中阳性标本34份,阳性率为80.95%;分离出39株病原菌,其中革兰阴性菌24株占61.54%,革兰阳性菌12株占30.77%,真菌3株占7.69%,前5位病原菌依次为铜绿假单胞菌、肺炎克雷伯菌、金黄色葡萄球菌、表皮葡萄球菌、大肠埃希菌,分别占30.77%、17.95%、15.38%、15.38%、12.82%;革兰阴性菌对亚胺培南敏感,革兰阳性菌对万古霉素敏感,真菌对氟康唑敏感。结论针对发生医院感染的患者,应及时做好药敏试验,根据药敏试验结果选用敏感的抗菌药物,并提供相应的治疗及护理。
Objective To analyze the etiological characteristics and related factors of nosocomial infections in patients with acute cerebrovascular diseases and provide basis for prevention of nosocomial infections. Methods The clinical data of 200 patients with acute cerebrovascular disease admitted to the hospital were retrospectively analyzed. The infection rate, infection site, pathogen distribution and drug resistance were analyzed statistically. Results Among the 200 patients with acute cerebrovascular disease, 32 cases were found nosocomial infection, the infection rate was 16.00%, 18 were male, the infection rate was 16.07%; the female was 14, the infection rate was 15.91%, the difference was not statistically significant; The main respiratory tract was 46.88%, followed by urinary tract, skin and soft tissue, gastrointestinal tract and facial features, accounting for 18.75%, 15.62%, 12.50% and 6.25% respectively; 34 positive samples were collected from 42 specimens, the positive rate 39 strains isolated, of which 24 strains of Gram-negative bacteria accounted for 61.54%, 12 Gram-positive bacteria accounted for 30.77%, fungi 3 accounted for 7.69%, the top 5 pathogens followed by Pseudomonas aeruginosa, Klebsiella pneumoniae, Staphylococcus aureus, Staphylococcus epidermidis and Escherichia coli accounted for 30.77%, 17.95%, 15.38%, 15.38% and 12.82% respectively. Gram-negative bacteria were sensitive to imipenem and Gram Positive bacteria are sensitive to vancomycin, and fungi are sensitive to fluconazole. Conclusion For patients with nosocomial infections, drug susceptibility testing should be done in time. Sensitive antibacterials should be selected according to the results of drug susceptibility testing and the corresponding treatments and nursing should be provided.