阿尔茨海默病患者医院感染的病原学分布及耐药性分析

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目的分析阿尔茨海默病医院感染病原学及其耐药性和产生原因,进行有针对性预防,以降低阿尔茨海默病患者医院感染率。方法回顾性分析2011年1月-2013年1月92例阿尔茨海默病医院感染患者的临床资料、病原菌分布及耐药性。结果阿尔茨海默病医院感染男性占64.13%,呼吸道感染最常见,占38.04%,2周内感染最多,占85.87%,基础疾病以高血压最多,占14.13%;感染病原菌主要有:革兰阴性菌71株,占60.68%,革兰阳性菌46株,占39.32%;革兰阴性菌中铜绿假单胞菌占20.51%,肺炎克雷伯菌占14.53%;革兰阳性菌中金黄色葡萄球菌占16.24%、凝固酶阴性葡萄球菌占11.11%,病原菌比较差异有统计学意义(P<0.05);耐药性分析,革兰阴性菌对亚胺培南、美罗培南耐药性均为0,对其它抗菌药物的耐药性在58.33%以上;革兰阳性菌对万古霉素耐药性均为0,其它病原菌的耐药性均在63.16%以上。结论阿尔茨海默病医院感染发生率高,细菌耐药性严重;铜绿假单胞菌、金黄色葡萄球菌是老年阿尔茨海默病医院感染主要致病菌。 Objective To analyze the nosocomial etiology, drug resistance and the causes of Alzheimer’s disease in hospital, and to provide targeted prevention to reduce the nosocomial infection rate in patients with Alzheimer’s disease. Methods The clinical data, pathogen distribution and drug resistance of 92 Alzheimer’s hospitalized patients from January 2011 to January 2013 were retrospectively analyzed. Results The incidence of nosocomial infections in Alzheimer’s disease was 64.13%. The most common respiratory infection was in 38.04%. The most common infection was in 2 weeks, accounting for 85.87%. The most common underlying disease was hypertension, accounting for 14.13%. The main pathogens of infection were Gram 71 strains of negative bacteria accounted for 60.68%, 46 strains of Gram-positive bacteria accounted for 39.32%; Gram-negative bacteria accounted for 20.51% of Pseudomonas aeruginosa, Klebsiella pneumoniae accounted for 14.53%; Gram-positive bacteria in golden yellow Staphylococcus accounted for 16.24%, coagulase-negative staphylococcus accounted for 11.11%, pathogenic bacteria was statistically significant difference (P <0.05); drug resistance analysis of gram-negative bacteria on imipenem, meropenem resistance were 0, resistance to other antibacterials was over 58.33%. Gram-positive bacteria were all resistant to vancomycin and the resistance of other pathogens was over 63.16%. Conclusion The incidence of nosocomial infections in Alzheimer’s disease is high and the bacterial resistance is serious. Pseudomonas aeruginosa and Staphylococcus aureus are the main pathogens of nosocomial infections in elderly patients with Alzheimer’s disease.
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