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, 任应国, 徐明超, 等. 急性脑卒中患者肺部感染的病原菌特点与耐药性分析[J]. 中华医院感染学杂志, 2016, 26(1):68-70.
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11.	方晴霞. 头孢哌酮/舒巴坦的使用量与鲍曼不动杆菌耐药性变迁的相关性分析[J]. 中国现代应用药学, 2012, 29(11):1039-1042.
12.	王惠凌, 苏立凯, 王德超, 等. 美洛西林钠与头孢哌酮舒巴坦治疗早发性脑卒中相关性肺炎临床观察[J]. 脑与神经疾病杂志, 2014, 22(2):132-135.
13.	张莉, 陈玲, 左壮, 等. 脑卒中患者医院获得性肺炎的病原学及耐药性分析[J]. 中华医院感染学杂志, 2010, 20(15):2335-2337.
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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, 吕媛, 薛峰, 等. 卫生部全国细菌耐药监测网(Mohnarin) 2011-2012 年革兰阴性菌耐药监测报告[J]. 中国临床药理学杂志, 2014, 30(3):260-277.
17.	李耘, 吕媛, 薛峰, 等. 卫生部全国细菌耐药监测网(Mohnarin) 2011-2012年革兰阳性菌耐药监测报告[J]. 中国临床药理学杂志, 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.	张弘, 张春玲, 徐德祥, 等. 肺炎克雷伯杆菌对抗菌药物耐药性变化的影响[J]. 现代生物医学进展, 2015, 15(2):328-331.

1. 胡科, 任应国, 徐明超, 等. 急性脑卒中患者肺部感染的病原菌特点与耐药性分析[J]. 中华医院感染学杂志, 2016, 26(1):68-70.
2. 陈玉珺, 李建设, 孙倩. 急性脑卒中患者肺部感染的病原菌特点及危险因素分析[J]. 中华医院感染学杂志, 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. 叶应妩, 王毓三, 申子瑜, 等. 全国临床检验操作规程[M]. 3版. 南京:东南大学出版社, 2006.
5. 陈民钧. 美国临床实验室标准化研究所2005年版有关药敏试验标准化更新要点[J]. 中华检验医学杂志, 2005, 28(4):449-451.
6. 宿英英, 黄旭升, 潘速跃, 等. 神经疾病并发医院获得性肺炎诊治共识[J]. 中华神经科杂志, 2012, 45(10):752-756.
7. 宋文芳, 谭湘淑, 韩新鹏, 等. 西京医院呼吸ICU 2008~2011年感染病原菌的调查及耐药性变迁[J]. 西安交通大学学报:医学版, 2012, 33(4):520-522.
8. 罗安志, 龙鸿川, 吴云, 等. 神经外科患者临床感染细菌分布和耐药性监测[J]. 中国民族民间医药, 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, 黄文祥, 盛家琦, 等. 重症监护病房革兰阴性杆菌连续六年耐药性监测研究[J]. 中华检验医学杂志, 2004, 27(11):752-756.
11. 方晴霞. 头孢哌酮/舒巴坦的使用量与鲍曼不动杆菌耐药性变迁的相关性分析[J]. 中国现代应用药学, 2012, 29(11):1039-1042.
12. 王惠凌, 苏立凯, 王德超, 等. 美洛西林钠与头孢哌酮舒巴坦治疗早发性脑卒中相关性肺炎临床观察[J]. 脑与神经疾病杂志, 2014, 22(2):132-135.
13. 张莉, 陈玲, 左壮, 等. 脑卒中患者医院获得性肺炎的病原学及耐药性分析[J]. 中华医院感染学杂志, 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, 吕媛, 薛峰, 等. 卫生部全国细菌耐药监测网(Mohnarin) 2011-2012 年革兰阴性菌耐药监测报告[J]. 中国临床药理学杂志, 2014, 30(3):260-277.
17. 李耘, 吕媛, 薛峰, 等. 卫生部全国细菌耐药监测网(Mohnarin) 2011-2012年革兰阳性菌耐药监测报告[J]. 中国临床药理学杂志, 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. 张弘, 张春玲, 徐德祥, 等. 肺炎克雷伯杆菌对抗菌药物耐药性变化的影响[J]. 现代生物医学进展, 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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