Epidemiological investigation of 217 middle-aged and elderly patients with stroke associated pneumonia
Objective To explore the epidemiological characteristics,risk factors,and pathogen distribution of stroke associated pneumonia in middle-aged and elderly patients.Methods A total of 822 middle-aged and elderly stroke patients treated in Second People's Hospital of Lishui from January 2020 to September 2023 were retrospectively selected,and they were divided into incidence group(n=217)and non-incidence group(n=605)based on the occurrence of stroke associated pneumonia.Clinical data,pathogen culture and drug sensitivity test results of two groups of patients were collected.Results There were significant differences in age,length of stay,smoking history,diabetes mellitus,hypertension,disturbance of consciousness,dysphagia,National Institutes of Health stroke scale(NIHSS)score at admission,hypoproteinemia,and gastric tube indwelling or not between two groups(P<0.05).Logistic regression analysis showed that age>65 years,length of stay≥15 days,smoking history,diabetes mellitus,disturbance of consciousness,dysphagia,NIHSS score≥13 points at admission,and indwelling gastric tube were risk factors for stroke associated pneumonia(P<0.05).A total of 251 pathogenic bacterial strains were cultured in the sputum of 217 patients,including 168 Gram negative bacteria,72 Gram positive bacteria,and 11 fungi.The main pathogens were 68 strains of Klebsiella pneumoniae(27.1%),50 strains of Pseudomonas aeruginosa(19.9%),41 strains of Staphylococcus aureus(16.3%),and 25 strains of Acinetobacter baumannii(10.0%).Klebsiella pneumoniae had a higher resistance rate to ampicillin and gentamicin,while Pseudomonas aeruginosa,Staphylococcus aureus,and Acinetobacter baumannii had a higher resistance rate to ampicillin and amoxicillin.Conclusion The occurrence of stroke associated pneumonia in middle-aged and elderly patients is related to age,comorbidities,disturbance of consciousness,dysphagia,indwelling gastric tubes,etc.,and there are many types of infectious pathogens.In clinical practice,it is necessary to strengthen the identification of high-risk factors and select appropriate antibiotics for treatment based on drug sensitivity tests.
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