老年住院患者多药耐药鲍氏不动杆菌肺部感染的临床研究  

Clinical study of multidrug-resistant Acinetobacter baumannii causing pulmonary infections in elderly hospitalized patients

作　　者：刘华[1] 钟亮尹[2] 王洪云[1] 

机构地区：[1]广东药学院附属第一医院内二科,广东广州510080 [2]广东药学院附属第一医院检验科,广东广州510080

出　　处：《中华医院感染学杂志》2013年第21期5310-5312,共3页Chinese Journal of Nosocomiology

基　　金：广东省自然科学基金项目(S2011010002100)

摘　　要：目的对老年住院患者多药耐药鲍氏不动杆菌致肺部感染进行临床研究,为临床合理用药提供依据。方法回顾性分析2009-2011年住院患者出现多药耐药鲍氏不动杆菌致肺部感染的201例老年患者临床资料,分析多药耐药鲍氏不动杆菌致肺部感染的基础疾病、抗菌药物应用及其耐药性。结果 201例多药耐药鲍氏不动杆菌致肺部感染的老年住院患者中103例基础疾病为肺部慢性疾病,占51.1%,明显高于其他基础疾病,差异有统计学意义(P<0.05);87例患者应用≥3种抗菌药物,占43.3%,明显高于应用抗菌药物<3种的患者,差异有统计学意义(P<0.05);鲍氏不动杆菌对常用抗菌药物中环丙沙星、头孢曲松、庆大霉素的耐药率>80.0%。结论肺部慢性疾病患者易感染鲍氏不动杆菌,同时应用抗菌药物的种类越多越易感染鲍氏不动杆菌,常规应用环丙沙星、头孢曲松、庆大霉素等常用抗菌药物进行治疗效果不佳。OBJECTIVE To study the incidence of pulmonary infections caused by muhidrug-resistant Acinetobacter baumannii isolated from the elderly hospitalized patients so as to guide reasonable clinical use of antibiotics. METHODS The clinical data of 201 elderly patients with muhidrug-resistant A. baumanii pulmonary infections who were hospitalized during 2009-2011 were retrospectively analyzed, then the underlying diseases, use of antibiotics and drug resistance were analyzed. RESULTS Of totally 201 elderly patients with pulmonary infections caused by multidrug-resistant A. baumannii, there were 103 （51. 1%） cases of chronic pulmonary disease, significantly higher than that of other chronic underlying diseases, the difference was significant（P〈0.05）. There were 87 （43.3%） cases of patients who used more than 3 antibiotics, significantly higher than that of those who used less than three antibiotics, the difference was significant （P〈0.05）. The drug resistance rates of the Acinetobacter baumannii to the commonly used antibiotics such as ciprofloxacin, ceftriaxone, and gentamicin were more than 80.0%. CONCLUSION The A. baumannii is the predominant pathogens causing chronic pulmonary disease; the more types of antibiotics we use, the higher the incidence of A. baumannii infections is. The commonly used antibiotics such as ciprofloxacin, ceftriaxone and gentamicin may achieve poor therapeutic effect.

关 键 词：老年患者 医院感染 多药耐药 鲍氏不动杆菌 肺部感染 

分 类 号：R563.1[医药卫生—呼吸系统]