Clinical Analysis Of Hospital-acquired Pneumonia In Patients With Severe Cerebrovascular Disease

Objective:To investigate the clinical characteristics,correlatetive factors andpathogenic characteristics of hospital-acquired pneumonia in patients with severecerebrovascular disease. To provide the reference for the prevention and treatment ofhospital-acquired pneumonia.Method:A retrospective study was performed on the hospital-acquired pneumoniapatients with severe cerebral vascular disease, who were admitted to the First People’sHospital of Chenzhou, from Jan2008to Dec2010. We recorded patients’ gender, age,time of hospitalization in ICU, state of consciousness, and so on. The bacterialdistribution and drug resistance were retrospectively analyzed. The correlatetivefactors of hospital-acquired pneumonia were analyzed.Result:1.Among368severe cerebrovascular patients,96cases were infected withhospital-acquired pneumonia, accounting for26.09%. The mortality rate of severecerebrovascular disease complicated by hospital-acquired pneumonia was10.42%.2.There were77strains (61.60%) of Gram-negative (G-) bacteria,34strains ofGram-positive (G+) bacteria (28.38%) and8strains of fungus (6.4%) among a total of118isolated bacterial strains. The G-bacteria were identified as Acinetobacterbaumannii (25strains), Psedomonas aeryginosa (24strains), Klebsiella pneumoniae(14strains), and Escherichia coli (10strains), etc. They had high sensitivity toImipenen and β-lactamase complex agents. Staphylococcus aureus was the main G+ bacteria. No G+bacteria resistant to vancomycin was found. Candida albicans was themain fungus.3.The severe cerebrovascular patients over the age of60, with long termhospitalization in ICU, disturbance of consciousness, invasive treatment,hyperglycomia, and the nasal feeding tube had significantly higher infection rate ofhospital-acquired pneumonia than those patients with younger age, short termhospitalization in ICU and without disturbance of consciousness, invasive treatmentand hyperglycomia.Conclusion:1.The infection rate of hospital-acquired pneumonia of severe cerebral vasculardisease was26.09%, and the mortality rate was10.42%.2.The main pathogens of hospital-acquired pneumonia were G-negative bacteria.Four most commom G-bacteria are Acinetobacter baumannii, Psedomonas aeryginosa,Klebsiella pneumoniae, and Escherichia coli. They were highly sensitive to Imipenenand β-lactamase complex agents. While Staphylococcus aureus was the main G+bacteria, and all of them sensitive to vancomycin. Candida albicans was the mainfungus.