Analysis of risk factors of pulmonary infection in senile stroke patients,drug-resistant bacteria and clinical pharmacist consultation guidance treatment effect

YU Lu; ZHENG Yulan; YANG Xuejiao; WANG Chunhua; SHEN Liang

doi:10.3969/j.issn.1007-8134.2025.01.009

Abstract：Objective To investigate the risk factors of combined lung infections in elderly patients with Cerebral Vascular Accident(CVA)and to observe the effect of joint consultation with clinical pharmacists on the treatment of multiple drug-resistant bacteria(MDR)and pan-drug resistance(PDR)infections by clinical pharmacists.Methods Three hundred cases of elderly CVA patients admitted to Xiangyang Central Hospital from January 2021 to June 2022 were used as observation subjects,and the cases with combined intrapulmonary infections were counted to investigate the factors related to pulmonary infections,and to observe the clinical effect of the clinical pharmacist's participation in guiding the treatment after the clinical pharmacist's participation.Results Out of 300 elderly patients with Cerebral Vascular Accident(CVA),80 cases had pulmonary infections,with an incidence rate of 26.67％.Advanced age(over 70 years),chronic lung disease,and a bed rest duration of 7 days or more were identified as independent risk factors for pulmonary infection in elderly CVA patients(P＜0.05).Through sputum specimens,a total of 92 strains of multiple drug-resistant bacteria(MDR)and pan-drug-resistant bacteria(PDR)were detected in 80 elderly CVA patients with pulmonary infections,including 64 cases of MDR and 26 cases of PDR,with 10 cases having dual infections.The MDR strains were primarily Escherichia coli(40.62％,26/64),Staphylococcus aureus(29.69％,19/64),and Enterobacter cloacae(29.69％,19/64);the PDR strains were mainly Acinetobacter baumannii(50％,13/26)and Pseudomonas aeruginosa(50％,13/26).A total of 75 patients fully accepted the medication advice from clinical pharmacists,accounting for 93.75％,including 58 MDR patients and 17 PDR patients;4 cases partially accepted the medication advice,accounting for 5％;and 1 case did not accept the medication advice,accounting for 1.25％,with an overall acceptance rate of 98.75％.Among the 58 MDR patients,50 were cured and 8 improved,with a total effectiveness rate of 100％;among the 17 PDR patients,15 were cured and 2 improved,also with a total effectiveness rate of 100％.Among the 58 MDR patients,52 had complete bacterial clearance and 6 had partial clearance,with a total clearance rate of 100％;among the 17 PDR-infected patients,13 had complete bacterial clearance,3 had partial clearance,and 1 patient had no clearance,resulting in a total clearance rate of 92.12％.Conclusions Advanced age,chronic lung diseases and long-term bed rest are all risk factors for elderly CVA patients to cause pulmonary infection.In clinical treatment,an effective prevention plan should be formulated for patients based on their existing high-risk factors to reduce the chance of infection.The participation of clinical pharmacists in the clinical treatment of patients can formulate more scientific and effective treatment plans for drug-resistant bacteria infections for them,and provide good clinical pharmaceutical services and pharmaceutical monitoring,which plays an especially important role in the prevention and treatment of MDR and PDR infections and ensuring the health of patients.