老年医院获得性肺炎患者不动杆菌属感染及耐药性分析  

Acinetobacterinfection in elderly patients with hospital acquired pneumonia and bacterial drug resistance

作　　者：全国莉[1] 崔海燕[1] 王春莲[1] 郭新林[2] 

机构地区：[1]南方医科大学第三附属医院呼吸科,广东广州510630 [2]南方医科大学第三附属医院感染科,广东广州510630

出　　处：《中华医院感染学杂志》2014年第23期5746-5748,共3页Chinese Journal of Nosocomiology

基　　金：广东省医学科研基金资助项目(A2010360)

摘　　要：目的研究医院获得性肺炎（HAP）患者不动杆菌属感染的临床特征以及其对常用抗菌药的耐药性,为临床合理用药提供指导。方法 2010年1月-2013年8月300例HAP老年患者纳入研究,年龄60-85岁,以NCCIS标准作为判定标准,采用K-B琼脂扩散法,分离、培养检测研究对象痰标本,数据采用WHONE 5.4进行统计分析。结果 300例HAP老年患者发生不动杆菌属感染198例,感染率66.00%;分离培养出的198株不动杆菌属中鲍氏不动杆菌148株占74.75%、鲁氏不动杆菌40株占20.20%、其他10株占5.05%;不动杆菌属对亚胺培南、头孢哌酮/舒巴坦、磷霉素等耐药率分别为10.61%、22.73%、47.98%;对头孢噻肟、环丙沙星、氯霉素、磺胺甲噁唑/甲氧苄啶等耐药率较高,分别为87.37%、80.81%、81.82%、81.32%。结论 HAP患者不动杆菌属感染占重要作用,其对多种抗菌药物存在耐药性,但是对亚胺培南、头孢哌酮/舒巴坦、磷霉素敏感性较高,因此在对症治疗过程中可考虑联合用药。OBJECTIVE To study the clinical features of Acinetobacter infection in elderly patients with hospital ac‐quired pneumonia （HAP） and its drug resistance to commonly used antibiotics ,so as to provide guidance for ra‐tional drug use .METHODS Totally 300 elderly HAP patient aged 60~85 years during Jan .2010 to Aug .2013 were included in this study with the NCCIS standard as the judgment criteria .The Kirby‐Bauer agar diffusion method was used to isolate and culture the sputum specimens from the subjects ,data were statistically analyzed by WHONE 5 .4 .RESULTS Totally 198 cases of Acinetobacter infection occurred in the 300 elderly HAP patients , the infection rate was 66 .00% .The 198 strains of Acinetobacter strains included 148 strains of Acinetobacter bau‐mannii （74 .75% ） ,40 strains of Acinetobacter lwof fii （20 .20% ） ,and 10 strains of other bacteria （5 .05% ） . The resistance of Acinetobacter to imipenem , cefoperazone/sulbactam , and phosphonomycin were 10 .61% , 22 .73% ,and 47 .98% ;its resistance to cefotaxime ,ciprofloxacin ,chloramphenicol ,and sulfamethoxazole/trime‐thoprim was higher ,87 .37% ,80 .81% ,81 .82% ,and 81 .32% ,respectively .CONCLUSION Acinetobacter infec‐tion plays an important role in hospital acquired pneumonia ,and it has resistance to many kinds of antimicrobial agents ,but its sensitivity to imipenem ,cefoperazone/sulbactam ,and phosphonomycin is still high .Therefore in the course of the symptomatic treatment ,drug combination could be considered .

关 键 词：医院获得性肺炎 不动杆菌属 耐药性 

分 类 号：R378[医药卫生—病原生物学]