COPD患者感染鲍曼不动杆菌的临床特征及预后分析  

Clinical features and prognosis analysis of COPD patients infected with acinetobacter baumannii

作　　者：吴驰[1] 黄江[1] 邹俊[1] 周仲伟[1] 刘跃建[1] 

机构地区：[1]四川省医学科学院 四川省人民医院呼吸科,四川成都610072

出　　处：《临床肺科杂志》2014年第9期1622-1624,共3页Journal of Clinical Pulmonary Medicine

摘　　要：目的探索慢性阻塞性肺疾病(COPD)患者感染鲍曼不动杆菌的临床特征,分析感染相关危险因子及预后相关因素。方法收集COPD患者标本,采用常规方法进行细菌培养、菌株鉴定及药敏试验,收集感染患者临床资料分析感染相关危险因子及预后因子。结果药敏试验显示鲍曼不动杆菌对美罗培南、头孢哌酮/舒巴坦敏感性稍高。COPD患者感染鲍曼不动杆菌的临床表现缺乏特异性,多因素分析显示脏器功能不全、机械通气、联合使用≥2种抗生素及使用时间≥14天是独立危险因素,有创导管和机械通气是独立预后因子。结论 COPD患者合并鲍曼不动杆菌感染与机械通气治疗及使用广谱抗生素以及脏器功能不全有关。机械通气及有创导管是感染的独立预后因子。避免不合理使用抗生素、避免长时间机械通气及不适当有创导管治疗是控制感染改善预后的主要途径。Objective To explore the clinical features and risk factors and prognostic factors of chronic ob-structive pulmonary disease （ COPD） patients infected with acinetobacter baumannii. Methods COPD patients were given bacterial culture, strain identification and susceptibility test to analyze infection-related risk factors and prognos-tic factors. Results acinetobacter baumannii showed slightly higher sensitivity to meropenem and cefoperazone/sul-bactam. The clinical manifestations of COPD patients infected with acinetobacter baumannii were lack of specificity. The independent risk factors for infection included multi-organ dysfunction, mechanical ventilation and usage of more than two kinds of antibiotics and treatment more than 14 days. Invasive catheters and mechanical ventilation was an independent prognostic factor. Conclusion for COPD patients,mechanical ventilation and the use of broad-spectrum antibiotics and organ dysfunction was independent risk factors for acinetobacter baumannii infection, treatment should be rational in accordance with antibiotic susceptibility results. prognosis is poor for patients with acinetobacter bau-mannii infection. Mechanical ventilation and invasive catheter were independent prognostic factors. Conclusion A-void irrational use of antibiotics or prolonged mechanical ventilation or improper treatment of invasive catheter can help to control infection and improve prognosis.

关 键 词：慢性阻塞性肺疾病 鲍曼不动杆菌 危险因素 预后分析 

分 类 号：R563.9[医药卫生—呼吸系统]