Bacteria Distribution and Drug Resistance Analysis in Patients with Acute Stroke Complicated with Pulmonary Infection_West China Medical Journal

Authors：

 LaiHaiou ¹ , SunJihong ² , YangZhuxing ³ , LiuXiaolin ² , ZhangYan ² , LiangLina ⁴ , HuXinyong ¹ , JiLi ¹ , ZhangNa ¹ , YinChenglong ¹ , QiZhanning ¹ ,  LiuYonghong ¹

1. Department of Neurology, Xianyang Hospital of Yan'an University, Xianyang, Shaanxi 712000, P. R. China;
2. Clinical Laboratory, Xianyang Hospital of Yan'an University, Xianyang, Shaanxi 712000, P. R. China;
3. Nosocomial Infection Management Office, Xianyang Hospital of Yan'an University, Xianyang, Shaanxi 712000, P. R. China;
4. Department of Rehabilitation, Xianyang Hospital of Yan'an University, Xianyang, Shaanxi 712000, P. R. China;

Corresponding?author：

LiuYonghong, Email: lyhb756@163.com

Keywords：

Acute stroke; Pulmonary infection; Tolerance; Metthicillin resistant Staphylococcus aureus; G^- bacilli

DOI：

10.7507/1002-0179.20160063

Video：

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Objective To analyze the pathogenic bacteria distribution, structure and characteristics of drug resistance in patients with acute stroke complicated with pulmonary infection, in order to provide reference for the prevention of hospital infection and rational use of antimicrobial agents. Methods A total of 864 clinical specimens of acute stroke complicated with pulmonary infection were chosen for study between January 2012 and December 2014. Separation and cultivation were done in accordance with the operation procedures regulated by the Ministry of Health. Drug sensitivity examination was done by Kirby-Bauer (k-b). Super-extensive spectrum β lactamase (ESBL) and methicillin resistant staphylococcus aureus (MRSA) were detected to analyze the bacterial species and resistance transition. Results A total of 864 samples were cultivated, in which G^-bacteria accounted for 61.2%. The main pathogenic bacteria was Klebsiella pneumoniae bacteria, Escherichia coli, Pseudomonas aeruginosa, Acinetobacter baumanmii and Staphylococcus aureus. Imipenem had high antimicrobial activity to G^-bacilli, especially to Escherichia coli and Klebsiella pneumoniae bacteria. Linezolid, vancomycin and teicoplanin had high antibacterial activity to staphylococcus aureus. Vancomycin resistant Staphylococcus aureus was not found. Ciprofloxacin had high antibacterial activity to Pseudomonas aeruginosa, while imipenem had low antibacterial activity to Pseudomonas aeruginosa. Amikacin had high antibacterial activity to acinetobacter. Conclusion G^-bacilli are predominant in acute stroke complicated with pulmonary infection. ESBLs and MRSA detection rate is high, and we should pay attention to the rational use of antibiotics to reduce drug resistance.

Citation： LaiHaiou, SunJihong, YangZhuxing, LiuXiaolin, ZhangYan, LiangLina, HuXinyong, JiLi, ZhangNa, YinChenglong, QiZhanning, LiuYonghong. Bacteria Distribution and Drug Resistance Analysis in Patients with Acute Stroke Complicated with Pulmonary Infection. West China Medical Journal, 2016, 31(2): 230-234. doi: 10.7507/1002-0179.20160063 Copy

1.	胡科, 任應國, 徐明超, 等. 急性腦卒中患者肺部感染的病原菌特點與耐藥性分析[J]. 中華醫院感染學雜志, 2016, 26(1):68-70.
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12.	王惠凌, 蘇立凱, 王德超, 等. 美洛西林鈉與頭孢哌酮舒巴坦治療早發性腦卒中相關性肺炎臨床觀察[J]. 腦與神經疾病雜志, 2014, 22(2):132-135.
13.	張莉, 陳玲, 左壯, 等. 腦卒中患者醫院獲得性肺炎的病原學及耐藥性分析[J]. 中華醫院感染學雜志, 2010, 20(15):2335-2337.
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16.	李耕, 呂媛, 薛峰, 等. 衛生部全國細菌耐藥監測網(Mohnarin) 2011-2012 年革蘭陰性菌耐藥監測報告[J]. 中國臨床藥理學雜志, 2014, 30(3):260-277.
17.	李耘, 呂媛, 薛峰, 等. 衛生部全國細菌耐藥監測網(Mohnarin) 2011-2012年革蘭陽性菌耐藥監測報告[J]. 中國臨床藥理學雜志, 2014, 30(3):251-259.
18.	Mona A, SalhaAZ, Maha A. Risk factor for the development of ventilator associated pneumonia in critically ill neonates[J]. J Atn Sci, 2012, 8(1):461-466.
19.	張弘, 張春玲, 徐德祥, 等. 肺炎克雷伯桿菌對抗菌藥物耐藥性變化的影響[J]. 現代生物醫學進展, 2015, 15(2):328-331.

1. 胡科, 任應國, 徐明超, 等. 急性腦卒中患者肺部感染的病原菌特點與耐藥性分析[J]. 中華醫院感染學雜志, 2016, 26(1):68-70.
2. 陳玉珺, 李建設, 孫倩. 急性腦卒中患者肺部感染的病原菌特點及危險因素分析[J]. 中華醫院感染學雜志, 2014, 24(6):1407-1409.
3. Upadya A, Thorevska N, Sena KN, et al. Predictors and consequences of pneumonia in critically ill patients with stroke[J]. J Crit Care, 2004, 19(1):16-22.
4. 葉應嫵, 王毓三, 申子瑜, 等. 全國臨床檢驗操作規程[M]. 3版. 南京:東南大學出版社, 2006.
5. 陳民鈞. 美國臨床實驗室標準化研究所2005年版有關藥敏試驗標準化更新要點[J]. 中華檢驗醫學雜志, 2005, 28(4):449-451.
6. 宿英英, 黃旭升, 潘速躍, 等. 神經疾病并發醫院獲得性肺炎診治共識[J]. 中華神經科雜志, 2012, 45(10):752-756.
7. 宋文芳, 譚湘淑, 韓新鵬, 等. 西京醫院呼吸ICU 2008~2011年感染病原菌的調查及耐藥性變遷[J]. 西安交通大學學報:醫學版, 2012, 33(4):520-522.
8. 羅安志, 龍鴻川, 吳云, 等. 神經外科患者臨床感染細菌分布和耐藥性監測[J]. 中國民族民間醫藥, 2011, 20(10):5-6.
9. Kofteridis DP, Papadakis JA, Bouros D, et al. Nosocomial lower respiratory tract infections:prevalence and risk factors in 14 Greek hospitals[J]. Eur J Clin Microbiol Infect Dis, 2004, 23(12):888-891.
10. 卓超, 黃文祥, 盛家琦, 等. 重癥監護病房革蘭陰性桿菌連續六年耐藥性監測研究[J]. 中華檢驗醫學雜志, 2004, 27(11):752-756.
11. 方晴霞. 頭孢哌酮/舒巴坦的使用量與鮑曼不動桿菌耐藥性變遷的相關性分析[J]. 中國現代應用藥學, 2012, 29(11):1039-1042.
12. 王惠凌, 蘇立凱, 王德超, 等. 美洛西林鈉與頭孢哌酮舒巴坦治療早發性腦卒中相關性肺炎臨床觀察[J]. 腦與神經疾病雜志, 2014, 22(2):132-135.
13. 張莉, 陳玲, 左壯, 等. 腦卒中患者醫院獲得性肺炎的病原學及耐藥性分析[J]. 中華醫院感染學雜志, 2010, 20(15):2335-2337.
14. Song JH, Hiramatsu K, Suh JY, et al. Emergence in Asian countries of Staphylococcus aureus with reduced susceptibility to vancomycin[J]. Antimicrob Agents Chemother, 2004, 48(12):4926-4928.
15. Howden BP, Davies JK, Johnson PD, et al. Reduced vancomycin susceptibility in Staphylococcus aureus, including vancomycin-intermediate and heterogeneous vancomycin-intermediate strains:resistance mechanisms, laboratory detection, and clinical implications[J]. Clin Microbiol Rev, 2010, 23(1):99-139.
16. 李耕, 呂媛, 薛峰, 等. 衛生部全國細菌耐藥監測網(Mohnarin) 2011-2012 年革蘭陰性菌耐藥監測報告[J]. 中國臨床藥理學雜志, 2014, 30(3):260-277.
17. 李耘, 呂媛, 薛峰, 等. 衛生部全國細菌耐藥監測網(Mohnarin) 2011-2012年革蘭陽性菌耐藥監測報告[J]. 中國臨床藥理學雜志, 2014, 30(3):251-259.
18. Mona A, SalhaAZ, Maha A. Risk factor for the development of ventilator associated pneumonia in critically ill neonates[J]. J Atn Sci, 2012, 8(1):461-466.
19. 張弘, 張春玲, 徐德祥, 等. 肺炎克雷伯桿菌對抗菌藥物耐藥性變化的影響[J]. 現代生物醫學進展, 2015, 15(2):328-331.

West China Medical Journal

Bacteria Distribution and Drug Resistance Analysis in Patients with Acute Stroke Complicated with Pulmonary Infection

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