Analysis of Risk Factors and Distribution of Pathogens in Stroke-associated Pneumonia in Middle Aged and Elderly Patients

LYU Zhe; LI Feng; SUN Wei; WANG Yao-hui

doi:10.3969/j.issn.1002-3429.2018.05.021

Abstract：Objective To investigate risk factors of stroke-associated pneumonia (SAP) in the middle-aged and elderly patients and distribution feature of pathogenic bacteria. Methods We enrolled 287 middle-aged and elder-ly patients with acute SAP admitted to our hospital from February 2015 to March 2017,and assigned them to SAP group (n=43) and non-SAP group(n=244),according to the occurrence of SAP. The clinical features in both groups were compared,and the risk factors for SAP in middle-aged and elderly patients and the distribution of pathogenic bacteria were analyzed. Results In middle-aged and elderly patients,60 years of age or older,smoking history,history of dia-betes,lung disease and stroke,posterior circulation stroke,dysphagia,disturbance of consciousness,mechanical venti-lation,nasal feeding and dehydration are independent risk factors for SAP. In SAP group,57 strains of pathogenic bac-teria were detected,of which 11 patients had mixed infection with two or more pathogenic bacteria. In addition,there were 17 strains of gram-positive cocci detected, mainly staphylococcus aureus; 38 strains of Gram-negative bacilli, mainly Klebsiella pneumoniae and 2 strains of fungi, Candida albicans. Conclusion Sixty years of age or older, smoking history,history of diabetes, lung disease history, history of stroke, posterior circulation stroke, dysphagia, disturbance of consciousness, mechanical ventilation, nasal feeding and dehydration are independent risk factors for SAP in middle-aged and elderly patients. Clinicians should focus on the related risk factors for SAP in the elderly and conduct targeted interventions. In the meantime,respiratory pathogens should be collected timely for pathogenic bacte-ria culture,which could be used to provide guidance for anti-infective therapy.