摘要
目的分析患者下呼吸道检出鲍曼不动杆菌的临床意义,评价敏感药物治疗鲍曼不动杆菌感染者的疗效。方法回顾性分析本院重症监护病房(ICU)痰培养有鲍曼不动杆菌生长的患者资料,比较临床判定为鲍曼不动杆菌定植者和感染者、死亡组和非死亡组的临床指标,分析各自的危险因素。对鲍曼不动杆菌进行体外药物敏感试验,了解敏感药物用于感染者的体内疗效。结果 192份阳性标本中94例为鲍曼不动杆菌定植者,64例为细菌感染者;68例死亡,90例存活。统计分析显示:严重脑外伤疾病者、血清白蛋白<35g/L、糖皮质激素使用时间>30d,为感染者的危险因素;机械通气>14d、有糖尿病病史者为定植者独立危险因素。相比于存活组,血清白蛋白<35g/L、合并其它细菌感染/定植、严重脑外伤疾病、恶性肿瘤基础疾病者、感染者居多是死亡组的危险因素。体外药敏实验显示,鲍曼不动杆菌对头孢哌酮/舒巴坦、米诺环素、亚胺培南耐药率较低,分别为10.1%、21.7%和33.9%。结论鲍曼不动杆菌致下呼吸道感染与患者免疫功能低下密切相关,而鲍曼不动杆菌定植者多为糖尿病患者,与接受机械通气有关。
Objective To analysis the clinical significance of Acinetobacter baumannii （ABA） found in lower respiratory tract, and to evaluate the effect of antimicrobial agents in treating Acinetobacter baumannii. Methods Data of patients in ICU whose sputum cultures had Acinetobacter baumannii growth were studied retrospectively. The clinical indexes of patients clinically diagnosed to be ABA colonization and ABA infection, and classified into death group and non-death group were compared, and then the risk factors were analyzed respectively. Sensitive experiment of ABA was performed in vitro as so to understand the curative effect of sensitive drugs on infectors in vivo. Results Of the 192 positive samples, 94 were ABA colonization, and 64 infected; 68 were dead, and 90 survived. Statistical analysis showed that independent risk factors for patients with ABA infection were as follows： Severe traumatic brain injury, serum albumin 〈35g/L and the use of corticosteroid 〉30 days, while duration of mechanical ventilation above two weeks and diabetes mellitus history were the risk factors for patients with ABA colonization. Compared with nondeath group, serum albumin 〈35g/L, combination with other bacterial infection/colonization, severe traumatic brain injury, malignancy, a majority of infectors were the risk factors in death group. In vitro drug sensitive experiment showed that ABA had a low resistance to cefoperazone/sulbactam, minocycline, imipenem, which was 10.1%,11.7% and 33.9% respectively. Conclusion Lower respiratory tract infection caused by ABA is closely related to low immune function of patients. Most of ABA colonization patients are patients with diabetes mellitus, and have something to do with the acceptance of mechanical ventilation.
出处
《中国抗生素杂志》
CAS
CSCD
北大核心
2012年第5期357-361,共5页
Chinese Journal of Antibiotics
关键词
鲍曼不动杆菌
感染
定植
重症监护病房
Acinetobacter baumannii
Infection
Colonization
Intensive care unit
