广泛耐药鲍曼不动杆菌医院获得性肺炎的临床特点  

Clinical characteristics of extensive drug-resistant Acinetobacter baumannii in patients with hospital-acquired pneumonia

作　　者：李裕军[1] 潘楚芝[2] 黄慕超 郭鹏豪[4] 方昌全 陈惠玲[6] 赵子文[1] 赵祝香[1] 

机构地区：[1]广州市第一人民医院呼吸内科,广东广州510180 [2]中山大学附属第三医院肝胆外科,广东广州510630 [3]广东药科大学附属第二医院呼吸内科,广东广州510300 [4]中山大学附属第一医院检验科微生物室,广东广州510080 [5]广州市红十字会医院呼吸内科,广东广州510250 [6]广州市第一人民医院检验科微生物室,广东广州510180

出　　处：《广州医科大学学报》2017年第2期24-28,共5页Academic Journal of Guangzhou Medical University

基　　金：广州市医药卫生科技项目(20151A011004)

摘　　要：目的:分析广泛耐药鲍曼不动杆菌(XDRAB)的流行菌株及医院获得性肺炎的特点。方法:收集广州市第一人民医院临床分离的非重复XDRAB菌株31株,进行分子流行病学分型,回顾性分析XDRAB肺炎的特点。结果:31株XDRAB被分为8个ST型,其中ST195最常见,占45.2%(14/31)。APACHEⅡ评分(P=0.034)、慢性阻塞性肺疾病(COPD)(P=0.012)和心脏疾病(P=0.016)是XDRAB肺炎的独立危险因素。XDRAB肺炎死亡率高达42.8%,但与非XDRAB肺炎相比,住院死亡率差异无统计学意义(P=0.582)。结论:鲍曼不动杆菌ST195广泛存在,XDRAB肺炎与COPD、心脏疾病及APACHEⅡ评分相关,但不增加死亡风险。Objective： To investigate the clinical characteristics of extensive drug-resistant Acinetobacter baumannii （XDRAB） epidemic strains and hospital-acquired pneumonia （HAP）. Methods： Thirty-one non- repeated XDRAB strains ,which were clinically isolated from Guangzhou First Municipal People＇s Hospital,were included and analyzed for molecular epidemiologic typing. The characteristics of XDRAB pneumonia were retrospectively analyzed. Results：Thirty-one strains of XDRAB were divided into 8 ST types, of which ST195 was the most common, accounting for 45.2% （14/31）. APACHE 11 score （P = 0.034） , chronic obstructive pulmonary disease（COPD） （P = 0. 012） and heart disease （P = 0.016） were independent risk factors for XDRAB pneumonia. The mortality rate of XDRAB pneumonia reached to 42.8%, but there was no statistically significant difference in hospital mortality （P= 0.582） compared with non-XDRAB pneumonia. Conclusion：Aeinetobacter baumannii ST195 exists widely. XDRAB pneumonia is associated with COPD, heart disease and APACHE 11 score, but does not increase the risk of death.

关 键 词：鲍曼不动杆菌 广泛耐药 多位点序列分型 医院获得性肺炎 

分 类 号：R563.1[医药卫生—呼吸系统]