The etiology and antibacterial drug resistance analysis of stroke associated pneumonia

ObjectiveTo investigate the etiology characteristics and drug resistance of stroke associated pneumonia(SAP) for providing the reference in antimicrobial agents rational use.

MethodsThe sputum culture data in 161 SAP patients were analyzed, the type of stroke was divided into the ischemic stroke and hemorrhagic stroke, and classified according to the mechanical ventilation.The detection rate of pathogen and drug sensitive test were analyzed.

ResultsAmong 161 SAP patients, 176 strains bacteria were detected, which included G^--bacteria(70.45%), G⁺-bacteria(7.39%) and fungi(22.16%).The G^--bacteria mainly included Klebsiella peneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa and E.coli.Twenty-six extended-spectyum β-lactamase strains were detected, which included 10 strains of E.coli and 16 strains of K.pneumoniae.The G⁺-bacteria mainly included Staphylococcus aureus, and the methicillin-resistant staphylococcus was not detected.Fungus was mainly Canidia albicans.Drug susceptibility test results showed that the G^--bacteria was more sensitive to amikacin and piperacillin-tazobactam, the G⁺ -bacteria was more sensitive to vancomycin and linezolid.Among 161 SAP cases, the ischemic stroke in 63 cases and hemorrhagic stroke in 98 cases were identified.One hundred cases treated with mechanical ventilation and 61cases treated without mechanical ventilation were found.The difference of the pathogenic bacteria composition between ischemic stroke and hemorrhagic stroke patients was statistically significant(P < 0.01 and P < 0.05).

ConclusionsThe G^--bacteria is mainly pathogenic bacteria of SAP, and the fungi infection and mixed infection with fungi increase gradually.Different type stroke and mechanical ventilation affect the the pathogenic bacteria composition of SAP, and the rational use of antimicrobial agents should be in accordance with the etiology characteristics of sputum culture.