抗菌药物治疗鲍曼不动杆菌肺炎的回顾性分析  

A retrospective analysis of antibiotic treatment of pneumonia caused by Acinetobacter baumannii

作　　者：许萌芽[1] 姚天赐[1] 张彧梅[2] 

机构地区：[1]厦门大学附属第一医院药学部,厦门361022 [2]厦门大学附属第一医院检验科,厦门361022

出　　处：《中国新药杂志》2013年第22期2702-2706,共5页Chinese Journal of New Drugs

摘　　要：目的:本文回顾性分析我院鲍曼不动杆菌肺炎患者抗菌药物的使用情况及治疗结果,以期为我院鲍曼不动杆菌感染患者的抗菌治疗提供依据。方法:对我院2011年1月-2012年12月收治的鲍曼不动杆菌(Acinetobacter baumannii,A.b)所致肺炎患者的临床基本资料、药敏情况、抗菌药物使用情况及治疗结果进行统计和分析。结果:48例鲍曼不动杆菌肺炎患者都存在严重原发病或免疫功能低下。在48株A.b中检出多重耐药鲍曼不动杆菌(MDR A.b)12株,A.b对亚胺培南耐药率最低(19.05%),其次依次为美罗培南(21.43%)、阿米卡星(27.90%)。使用频次列前5位的抗菌药物依次为美罗培南、阿米卡星、莫西沙星、头孢吡肟和左氧氟沙星。单一用药24例,二联用药21例,三联用药3例。治疗有效率37.5%(18/48)。结论:该院肺部感染A.b存在多重耐药现象,抗菌治疗以单一及二联用药为主,治疗有效率低,应参照药敏结果联合用药,以提高治疗有效率。Objective： To retrospectively analyze the current antibiotic therapy of Acinetobacter baumannii- caused pneumonia in patients in our hospital and to provide the basis for clinically rational use of antibiotics in pneumonic patients infected by Acinetobacter baumannii. Methods： The basic information of patients, antibiotic susceptibility, the application of antibiotics and their therapeutic effects in pneumonic patients infected by Acineto- bacter baumannii in our hospital from January 2011 to December 2012 were analyzed retrospectively. Results： In 48 patients with Acinetobacter baumannii-caused pneumonia, most patients suffered from severe basic diseases or suppressed immunity. A tatol of 12 strains of multidrug-resistant Acinetobacter baumannii were detected in 48 pa- tients. Acinetobacter baumannii had the lowest resistance rate to imipenem （ 19.05% ） , followed by meropenem （21.43%） and amikacin （27.90%）. Top 5 frequently used antibiotics for treating Acinetobacter baumannii infec- tions were meropenem, amikacin, moxifloxacin, cefepime and levofloxacin. In 48 patients with Acinetobacter bau- mannii-caused pneumonia, single-drug therapy was used in 24, two-drug therapy in 21, and three-drug therapy in 3. Total effective rate was 37.5 % （18/48）. Conclusion： Acinetobacter baumanii has multiple drug resistance to antibiotics. Single-drug therapy and two-drug therapy have been the main therapeutic regimens, but the effective rate is low. Thus, the therapeutic effects should be improved depending on antibiotic sensitivity test and combina- tion drug therapy.

关 键 词：鲍曼不动杆菌 肺炎 抗菌药物 回顾性分析 

分 类 号：R978.1[医药卫生—药品]