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| Analysis on the risk factors and anti-infective treatment of stroke-associated pneumonia in NICU in our hospital |
| CHOU Xiaohua1 GAO Xing1 LIU Tianya1 WANG Fengzhen1 HAN Qiang1 ZHANG Xiancheng2 |
1.Department of Pharmacy, Affiliated Hospital of Xuzhou Medical University, Jiangsu Province, Xuzhou 221006, China;
2.School of Pharmacy, Xuzhou Medical University, Jiangsu Province, Xuzhou 221004, China |
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Abstract Objective To analyze the risk factors and pathogens characteristics of stroke-associated pneumonia in neurological intensive care unit (NICU) of Affiliated Hospital of Xuzhou Medical University ("our hospital" for short), so as to provide evidence for antimicrobial drug choice. Methods Clinical data of 154 patients with stroke from January 2016 to June 2017 in our hospital. The multivariate Logistic regression analysis was used to analyze the risk factors of stroke-associated pneumonia, and the main pathogenic bacteria and drug resistance statistically. It was studied that how to carry out effective anti-infective therapy on the main pathogens. Results Multivariate regression analysis showed significant differences (P ＜ 0.05) in several factors such as age≥65 years, diabetes, dysphagia, hyperglycemia，hypoproteinemia，and high leukocyte count. The main pathogens were G- bacteria 59.09% in proportion, the top three major pathogens were Klebsiella pneumoniae, Staphylococcus aureus and Pseudomonas aeruginosa. The main pathogens showed severe multidrug resistance. G- bacteria were more sensitive to Tigecycline, Amikacin and so on. Staphylococcus aureus was more sensitive to Vancomycin, Linezolid, Tigecycline, Amikacin and Cotrimoxazole. Conclusion Risk factors of stroke-associated pneumonia in NICU of our hospital include advanced age, diabetes, dysphagia, hyperglycemia, hypoproteinemia, and high leukocyte count, etc. G- bacteria were the main pathogens. The main pathogens show severe multidrug resistance. Amikacin, Tigecycline can be used as the preferred antibacterial drugs, MRSA infection can also choose Vancomycin, Linezolid and other antibacterial drugs.
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[1] 贾建平，陈生弟.神经病学[M].7版.北京：人民卫生出版社，2013，170.
[2] Dijkgraaf MG，Jan-Dirk V，Nederkoorn PJ，et al. Post-stroke infection： A systematic review and meta-analysis [J]. Bmc Neurology，2011，11（1）：1-7.
[3] 卒中相关性肺炎诊治中国专家共识组.卒中相关性肺炎诊治中国专家共识[J].中华内科学杂志，2010，49（12）：1075-1078.
[4] Hiker R，Poetter C，Findeisen N，et al. Nosocomial pneumonia after acute stroke：implications for neurological intensive care mendicine [J]. Stroke，2003，34（4）：975-981.
[5] 孙克玉，李响，封启明，等.老年卒中相关性肺炎发生及预后的临床探讨[J].皖南医学院学报，2012，31（4）：309-311.
[6] 杨靖，王新兰，徐文武，等.急性重症卒中患者卒中相关性肺炎发病的危险因素分析[J].山西医药杂志，2017，46（8）：875-878.
[7] 中华神经科学会.各类脑血管疾病的诊断要点[J].中华神经科杂志，1996，29（6）：379-380.
[8] 纪风兵，卓超.卒中相关性肺炎的研究进展[J].广东医学，2012，33（7）：1029-1031.
[9] 石彦杰，郑惠，郑春雷，等.卒中相关性肺炎病原菌分布特征及其与免疫系统功能变化的关系[J].中国病原生物学杂志，2017，12（2）：178-181.
[10] 李燕华，李吕力，罗永坚，等.神经内科重症监护病房医院感染病原菌分布及预防措施[J].中国老年学杂志，2013， 33（22）：5698-5699.
[11] 张晶，赵书萱，吴云兰，等.综合性护理干预在脑卒中相关性肺炎中的应用研究[J].中国现代医生，2016，54（13）：147-149，152.
[12] 黄旭军，毛园清，聂根，等.ICU住院患者感染病原菌分布及耐药性分析[J].中华医院感染学杂志，2017，27（9）：1963-1966.
[13] 吕晶，刘昱材，赵志国.卒中相关性肺炎研究进展[J].湖南中医杂志，2017，33（2）：147-152.
[14] 黄彦飞，张静，胡琼燕，等.个体化护理干预在老年脑卒中患者中的应用[J].中国现代医生，2016，54（35）：143-145. |
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