PDF(Pubmed)
Abstract：
Patients with brain injuries are at a heightened susceptibility to bacterial pneumonia, and the timely initiation of empiric antibiotic treatment has been shown to substantially reduce mortality rates. Nevertheless, there is a need for knowledge regarding the resistance and prevalence of pulmonary bacterial infections in this patient population. To address this gap, a retrospective study was conducted at a neurosurgical emergency center, focusing on patients with brain injuries. Among the entire patient population, a total of 739 individuals (18.23%) were identified as having bacterial pneumonia, consisting of 1489 strains of Gram-negative bacteria and 205 strains of Gram-positive bacteria. The resistance of Klebsiella pneumoniae to imipenem exhibited a significant increase, rising from 21.74% in 2009 to 96.67% in 2018, and subsequently reaching 48.47% in 2021. Acinetobacter baumannii displayed resistance rates exceeding 80.0% against multiple antibiotics. The resistance profile of Pseudomonas aeruginosa was relatively low. The proportion of Staphylococcus aureus reached its peak at 18.70% in 2016, but experienced a decline to 7.83% in 2021. The abundance of Gram-negative bacteria exceeded that of Gram-positive bacteria by a factor of 5.96. Klebsiella pneumoniae, Acinetobacter baumannii, and Staphylococcus aureus are prominent pathogens characterized by limited antibiotic choices and scarce treatment alternatives for the isolated strains.
摘要：
脑损伤患者对细菌性肺炎的易感性更高，及时开始经验性抗生素治疗已被证明可以大大降低死亡率。然而，需要了解该患者人群中肺部细菌感染的耐药性和患病率.为了解决这个差距，在神经外科急救中心进行了一项回顾性研究，专注于脑损伤患者。在整个患者群体中，共有739人(18.23%)被确认患有细菌性肺炎，由1489株革兰氏阴性菌和205株革兰氏阳性菌组成。肺炎克雷伯菌对亚胺培南的耐药性明显增加,从2009年的21.74%上升至2018年的96.67%，随后在2021年达到48.47%。鲍曼不动杆菌对多种抗生素的耐药率超过80.0%。铜绿假单胞菌的耐药性相对较低。金黄色葡萄球菌的比例在2016年达到峰值，达到18.70%，但在2021年下降到7.83%。革兰氏阴性菌的丰度超过革兰氏阳性菌的5.96倍。肺炎克雷伯菌,鲍曼不动杆菌,金黄色葡萄球菌是突出的病原体，其特征是抗生素选择有限，分离菌株的治疗替代方案稀缺。
