摘要：目的：了解引起脑卒中并医院感染细菌分布及耐药趋势，为临床治疗及感染的控制提供参考。方法：对本院2002年6月至2004年6月脑卒中并医院感染患者标本中分离出的致病菌并鉴定，按美国临床实验标准委员会1999年判断标准用纸片扩散法进行敏感试验。结果：从细菌的分布来看，脑卒中并医院感染部位主要以下呼吸道为主，共分离病原菌263株，革兰阳性菌 73株，其中甲氧西林耐药株分别占金黄色葡萄球菌和凝固酶阴性葡萄球菌的41.7 %和44.0 %；革兰阴性菌183株，主要以铜绿假单胞菌、肺炎克雷伯菌、大肠埃希菌、不动杆菌、嗜麦芽假单胞菌多见，其中产超广谱β内酰胺酶的革兰阴性杆菌占40.7%，监测中未发现万古霉素耐药的金黄色葡萄球菌，革兰阴性杆菌对亚胺培南耐药率最低，对氨苄西林、哌拉西林、环丙沙星耐药率较高。结论：脑卒中并医院感染的多重耐药问题相当严重，加强病原菌分布及耐药率监测，指导临床合理用药具有重大意义。

    关健词：医院感染；耐药性；细菌分布

    Characteristics and Resistancs Patterns Pathogens for Nosocomial Infection in Patients with Stroke

    MA Zhi-yuan，CAI Zhi-jun，YE Zhi-dong

    (The Second People's Hospital of Zhanjiang，Guangdong Zhanjiang 524003，China)

    Abstract： Objective: To determine the tendency of bacterial distribution and resistance of hospital infections and to provide the reference for the clinical treatment and infection control with strokes. Method: Bacteria were isolated and indenfied from JUN.2002 to JUN.2004,and bacteria`s drug susceptibility test was performed on strains using standard Kirby-Bauer method according with guidelines of NCCLS(1999).Result: According to the distributions of bacteria,lower respiratory tract was the most frequent infection site,Total of 263 straints pathogens were isolated, among them 73 strains were Gram-positive cocci.Meticillin resistant strains accounted for 41.7%and 44.0%of Staphylococcus aureus and CNS,respectively There were 183 strains Gram-negative bacilli.the most common pathogens of them were pseudomonas ruginosa,Klebsiella pneumoniae, Escherichia coli, Acinetobacter,Stenotrophomonas .The ESBL producing strains accounted for 22.4% of Gram-negative bacilli .in our surveillance,there were no vancomycin resistant strains of S.aureus.The highest susceptible to Gram-negative bacilli is imipenem.Resistant rates of Gram-negative bacilli against ampicillin ,piperacillin,fluoroquinolines were higher.Conclusion: Multi-drug resistance of the nosocomial infection bacteria is a serious problem.It has a very important clinical value to inspect the bacterial spectrum and drug resistance. ......