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目的:探讨老年脑卒中住院患者发生院内感染的病原学诊断。方法:于2013年1月-2015年12月,选取30例在住院期间发生院内感染的老年脑卒中患者,采集患者感染发生部位的分泌物或引流液进行病原学检查和药敏试验。结果:共检出42株病原菌,革兰阴性杆菌占69.05%,革兰阳性球菌占26.19%,真菌占4.76%;病原菌前3位分别为铜绿假单胞菌、金黄色葡萄球菌、大肠埃希菌,占百分比分别为28.57%、19.05%、16.67%。铜绿假单胞菌、大肠埃希菌对氨苄西林的药物敏感性均较低,对亚胺培南、头胞哌酮舒巴坦的药物敏感性均较高;金黄色葡萄球菌对青霉素的药物敏感性极低,对万古霉素和替考拉宁的药物敏感性极高。结论:导致老年脑卒中患者发生院内感染的病原菌较多,临床上应根据病原菌的耐药性选择合适的药物进行防治。
Objective: To investigate the etiological diagnosis of nosocomial infection in elderly stroke patients. Methods: From January 2013 to December 2015, 30 elderly stroke patients with nosocomial infections during hospitalization were selected and the secretions or drainage fluids of the infected sites were collected for etiological examination and drug susceptibility testing. Results: A total of 42 pathogenic bacteria were detected, accounting for 69.05% for Gram-negative bacilli, 26.19% for Gram-positive cocci, and 4.76% for fungi. The top three pathogens were Pseudomonas aeruginosa, Staphylococcus aureus, Escherichia coli Bacteria, accounting for 28.57%, 19.05% and 16.67%, respectively. Pseudomonas aeruginosa, Escherichia coli ampicillin drug sensitivity are low, imipenem, cephalosporin sulbactam drug sensitivity are high; Staphylococcus aureus penicillin drug Very low sensitivity, high sensitivity to vancomycin and teicoplanin. Conclusion: There are many pathogens causing nosocomial infection in elderly stroke patients. Clinically, appropriate drugs should be selected for prevention and treatment according to the drug resistance of pathogens.