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| Analysis of risk factors and pathogenic bacteria in patients with acute stroke complicated with severe pneumonia |
| LI Kuangyi FENG Jinfang WU Zhixin KUANG Minhua ZHONG Juying CAI Hairong HONG Dandong |
| Department of Emergency, Foshan Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Chinese Medicine, Guangdong Province, Foshan 528000, China |
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Abstract Objective To investigate the risk factors and pathogenic bacteria distribution in patients with acute stroke complicated with severe pneumonia. Methods A total of 431 patients with acute stroke treated in Foshan Hospital Traditional Chinese Medicine, Guangdong Province from January 2016 to May 2019 were retrospectively analyzed. According to whether or not with severe pneumonia, they were divided into severe pneumonia group (53 cases) and without severe pneumonia group (378 cases). The risk factors of acute stroke complicated with severe pneumonia, the type of pathogenic bacteria in patients and the results of drug sensitivity were analyzed. Results The age, hospital stay, Glasgow coma scale (GCS) score, national institutes of health stroke scale (NIHSS) score, invasive procedure, chronic obstructive pulmonary disease (COPD) and diabetes were compared between the two groups, and the differences were statistically significant (P ＜ 0.05). Logistic regression analysis showed that age (OR = 1.131), GCS score (OR = 0.663), NIHSS score (OR = 2.467), and invasive procedures (OR = 16.890) were the influencing factors of stroke complicated with severe pneumonia (P ＜ 0.05). Among the 431 patients with acute stroke, 53 cases were secondary to severe pneumonia, with an infection rate of 12.3%. 38 strains of pathogenic bacteria were cultured, including 28 strains of Gram-negative bacteria (73.7%), 8 strains of Gram-positive bacteria (21.1%), and 2 strains of fungi (5.2%). The top three Gram-negative bacteria were Pseudomonas aeruginosa, Acinetobacter baumannii, and Escherichia coli. Gram-positive bacteria were mainly Staphylococcus aureus and fungi were Candida albicans. Pseudomonas aeruginosa, Acinetobacter baumannii, Escherichia coli and Klebsiella pneumoniae had a higher resistance rate to Cefazolin, Ceftriaxone, Ciprofloxacin, Levofloxacin and Gentamicin (resistant drug rate＞50%); more sensitive to Carbapenem antibiotics meropenem and Imipenem, and Quinolones ciprofloxacin and Levofloxacin (resistance rate＜20%). Conclusion In patients with acute stroke, it is necessary to fully evaluate the underlying diseases of patients and adopt an active treatment measure. In terms of pathogenic bacteria, acute stroke complicated with severe pneumonia is mainly caused by Gram-negative. In the choice of early antibiotics, attention should be paid to avoiding the abuse of antibiotics and reducing the emergence of resistant strains.
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