Objective To investigate the distribution and antimicrobial resistance of pathogens causing pneumonia in acute stroke patients,and guide clinical antimicrobial use.Methods Patients with stroke-associated pneumonia (SAP)admitted to a tertiary first-class hospital from 2008 to 2013 were investigated retrospectively,distribution and antimicrobial susceptibility testing results of pathogens from sputum were analyzed.Results A total of 98 pa-tients with SAP were investigated,124 stains were isolated from sputum specimens,75 strains (60.48% )were gram-negative bacteria,44 (35.49% )were gram-positive bacteria,and 5 (4.03% )were fungi. There were 21 cases of mixed infection (21.43% ),bacterial alterations during treatment process existed among 23 cases(23.47% ).The top 4 isolated pathogens were Staphylococcus aureus (S. aureus,n= 43,34.68% ),Klebsiella pneumoniae (K. pneumoniae,n= 19,15.32% ),Pseudomonasaeruginosa(P. aeruginosa,n= 18,14.52% ),and Acinetobacterbau-mannii(A. baumannii,n= 18,14.52% ). Antimicrobial resistance rates of K. pneumoniae were all <32% ,and susceptibility rates to ceftazidime,piperacillin/tazobactam,imipenem,ciprofloxacin,levofloxacin,amikacin,and tobramycin were all 100% . Both A.baumannii and P.aeruginosa showed severe multidrug resistance. Resistance rates of A.baumannii to ceftazidime was >80% ,resistance rates of P.aeruginosa to imipenem was 33 .33% . No resistant strains were detected among fungi.Conclusion The main pathogens causing SAP in this hospital are S.au-reus,K.pneumoniae,A.baumannii,and P.aeruginosa,except K.pneumoniae,the other strains are severely re-sistant to antimicrobial agents,clinicians should choose antimicrobial agents according to the distribution character-istics and antimicrobial susceptibility testing results.

Objective To explore the effect of bronchofibroscope joint mechanical ventilation on the treatment of the geratie surgery postoperative patients with acute respiratory failure.Methods 62 geratic surgery postoperagedative patients with acute respiratory failure were randomly divided into two groups(control group and treatment group).The treatment group(n=32) applyed bronchofibroscope aspiration and/or bronchial lavage joint mechanical ventilation.The control group(n=30) were treated only with mechanical ventilation.Compare with two groups parameters of arterial blood gas,the time of mechanical ventilation,average in ICU,success rate one time pull out windpipe conduit and case fatality rate.Results Compare with the control group,the treatment group patients parameters of arterial blood gas had been improved significantly;the time of mechanical ventilation and average in ICU had been cut short significantly;all showed a statistical difference(P<0.05).Success rate one time pull out windpipe conduit and case fatality rate were better than the control group,but there were no significant difference(P>0.05).Conclusion The effect of bronchofibroscope joint mechanical ventilation to treat the geratic surgery postoperative patients with acute respiratory failure was better than only mechanical ventilation,which can decrease the time of mechanical ventilation and average in ICU.The method was worth to spread.