COPD并呼吸衰竭患者院内感染不动杆菌分析  

Clinical analysis of COPD patients complicated with respiratory failure nosocomial infected with acinetobacter

作　　者：赵罗亚 王玲[1] 卜文炳 潘美荣[1] 汪利霞[1] 

机构地区：[1]上海市江湾医院呼吸内科,上海200434

出　　处：《临床肺科杂志》2013年第6期1018-1019,共2页Journal of Clinical Pulmonary Medicine

基　　金：上海市虹口区卫生局重点课题(虹卫1002-08)

摘　　要：目的分析COPD并呼吸衰竭患者发生鲍曼不动杆菌所致医院获得性肺炎(HAP)临床耐药情况。方法收集COPD并呼吸衰竭患者发生HAP合格痰标本进行分离培养,进行鉴定和药敏试验。结果 COPD并呼吸衰竭患者分离到36例鲍曼不动杆菌所致HAP,对头孢类、氨基糖苷类、喹诺酮类等常用抗生素耐药率大于50%,对亚胺培南耐药率为25%。患者平均年龄79.5岁,近期应用抗生素、糖皮质激素、制酸剂、接受呼吸机辅助通气者比例高,多合并营养不良、多种合并症,死亡率为25%。结论 COPD呼吸衰竭患者并HAP,高龄,致病菌为鲍曼不动杆菌时,呈多重耐药,应评估危险因素,早期靶向治疗,规范使用抗生素,减少死亡率。Objective To analyze the drug resistance of COPD patients complicated with respiratory failure and hospital-acquired pneumonia （HAP） caused by Aeinetobacter baumannii. Methods Qualified sputum samples of COPD patients complicated with respira- tory failure and HAP were isolated and cultured to test and identify its drug sensitivity. Results 6 strains of acinetobacter baumannii were isolated from the samples ,which caused HAP and showed a high resistance rate to commonly used antibiotics. To cephalosporins, amin- og]yeosides, fluoroquinolones and other commonly used antibiotic resistance rates greater than 50% , 25% resistance to imipenem. The av- erage age of the patients was 79.5 years, the recent use of antibiotics, cortieosteroids, antacids, accept the high proportion of mechanical ventilation by more complicated malnutrition, a variety of complications, mortality rate was 25%. Conclusion COPD patients with re- spiratory failure and HAP, senior citizens, pathogens were Aeinetobaeter baumannii, was multi -drug resistance, should assess the risk factors, early targeted therapy to regulate the use of antibiotics to reduce the mortality rate.

关 键 词：医院获得性肺炎 COPD呼吸衰竭 鲍曼不动杆菌 抗生素 耐药性 

分 类 号：R563.9[医药卫生—呼吸系统]