铜绿假单胞菌肺炎52例临床及药物敏感性分析  

Clinical features and antibiotic susceptibility of 52 cases of pneumonia caused by Pseudomonas aeruginosa

作　　者：龚燕[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院卢湾分院呼吸科,200025

出　　处：《中国感染与化疗杂志》2011年第3期178-180,共3页Chinese Journal of Infection and Chemotherapy

摘　　要：目的分析和总结铜绿假单胞菌肺炎的临床特点和对抗菌药物敏感性。方法对52例铜绿假单胞菌肺炎的临床资料进行统计分析,以K-B法测定该菌对抗菌药物敏感性。结果 52例中,老年患者42例（80.8%）,患有基础疾病患者52例（100%）,其中12例（23.1%）有慢性阻塞性肺疾病的病史,41例（78.8%）存在免疫功能低下;院外感染25例（48.1%）,医院感染27例（51.9%）。临床表现主要为咳嗽、咳痰52例（100%）,发热15例（28.8%）,呼吸困难36例（69.2%）;X线胸片均呈现程度不等肺部浸润阴影。药敏试验检测表明,除了对哌拉西林-他唑巴坦、亚胺培南-西司他丁、头孢哌酮-舒巴坦、美罗培南、阿米卡星、奈替米星、头孢吡肟和妥布霉素比较敏感外（97.5%~74.1%）,该菌广泛耐药（2.5%~44.2%）。结论铜绿假单胞菌肺炎好发于老年、有基础疾病及免疫功能低下者,及早进行细菌药敏试验以选择敏感的抗菌药物将改善预后。Objective To analyze and summarize the clinical features and antibiotic susceptibility of pneumonia caused by P.aeruginosa.MethodsThe clinical data of 52 cases of pneumonia due to P.aeruginosa were retrospectively reviewed.The susceptibility of P.aeruginosa strains to various antibiotics was determined using Kirby-Bauer method.ResultsOf the 52 cases,42（80.8%） were elderly patients.All patients had underlying disease,including chronic obstructive pulmonary disease（12,23.1%） and immunodeficiency（41,78.85%）.Community infection and nosocomial infection accounted for 48.1%（n=25） and 51.9%（n=27）,respectively.The clinical symptoms were mainly cough and expectoration（100%）,fever（15,28.8%）,and dyspnea（36,69.2%）.Chest X-ray showed various degree of pulmonary infiltration.Susceptibility testing indicated that the P.aeruginosa strains were relatively susceptible to piperacillin-tazobactam,imipenem-cilastatin,cefoperazone-sulbactam,meropenem,amikacin,netilmicin,cefepime and tobramycin（97.5%-74.1% susceptible）,but were highly resistant to the remaining antibiotics（2.5%-44.2% susceptible）.ConclusionsThe risk factors of P.aeruginosa pneumonia include ageing,underlying diseases and immunodeficiency.Early treatment with active antibiotic and timely susceptibility testing will improve the outcome.

关 键 词：铜绿假单胞菌 肺炎 药物敏感性 

分 类 号：R563.1[医药卫生—呼吸系统]