多药耐药鲍氏不动杆菌相关肺部感染抗菌药物使用情况  

Antibiotics Use in Patients with Multidrug Resistant Acinetobacter Baumannii Associated Pulmonary Infection

作　　者：许月影 洪丽帆 刁玉兰 XU Yueying;HONG Lifan;DIAO Yulan(Yangdong District People’s Hospital,Yangjiang 529900,China)

机构地区：[1]广东省阳江市阳东区人民医院,广东阳江529900

出　　处：《中国医学创新》2020年第18期165-168,共4页Medical Innovation of China

基　　金：阳江市科技计划项目(社发[2018]121)。

摘　　要：目的:调查本院多药耐药鲍氏不动杆菌相关肺部感染治疗中抗菌药物使用情况.方法:选取2016年1月-2018年12月本院肺部感染患者921例(分离出921株鲍氏不动杆菌菌株)的临床资料进行回顾性分析.按耐药情况分为多药耐药鲍氏不动杆菌相关肺部感染组(多药耐药组,n=336)和非多药耐药鲍氏不动杆菌相关肺部感染组(非多药耐药组,n=585).分析多药耐药组不同年份各类抗菌药物使用情况,分析两组不同年份的粗死亡率及不同抗菌药物的治疗效果.结果:多药耐药组2016年出院时与出院后1个月,2017年出院时、出院后2周及1个月粗死亡率均明显高于非多药耐药组(P<0.05).多药耐药组2016-2018年使用的抗菌药物均主要以碳青霉烯类为主.多药耐药组使用碳青霉烯类、碳青霉烯+头孢菌素抗菌药物治疗总有效率均明显低于非多药耐药组(P<0.05).结论:多药耐药鲍氏不动杆菌相关肺部感染患者粗死亡率较高,在治疗中主要应用碳青霉烯类,但治疗效果不如非多药耐药鲍氏不动杆菌相关肺部感染.Objective:To investigate the use of antibiotics in the treatment of multidrug resistant Acinetobacter baumannii associated pulmonary infection.Method:The clinical data of 921 patients(921 strains of Acinetobacter baumannii)with pulmonary infection in our hospital from January 2016 to December 2018 were analyzed retrospectively.According to drug resistance,they were divided into multidrug resistant Acinetobacter baumannii related pulmonary infection group(multidrug resistance group,n=336)and non-multidrug resistant Acinetobacter baumannii related pulmonary infection group(non-multidrug resistance group,n=585).The use of various antibiotics in different years in the multidrug resistance group was analyzed,and the crude death rate and therapeutic effect of different antibiotics in different years in the two groups were analyzed.Result:The crude death rates at the time of discharge and 1 month after discharge in 2016,2 weeks after discharge and 1 month after discharge in 2017 of the multidrug resistance group were significantly higher than those of the non-multidrug resistance group(P<0.05).Carbapenems were the major antibiotics used in the multi-drug resistance group from 2016 to 2018.The total effective rate of carbapenems,carbapenems+cephalosporins in the multi-drug resistance group were significantly lower than those in the non-multidrug resistance group(P<0.05).Conclusion:The crude mortality rate of patients with multidrug resistant Acinetobacter baumannii related pulmonary infection is higher.Carbapenems are mainly used in the treatment,but the treatment effect is not as good as that of non-multidrug resistant Acinetobacter baumannii related pulmonary infection.

关 键 词：多药耐药 鲍氏不动杆菌 相关肺部感染 抗菌药物 粗死亡率 

分 类 号：R563.1[医药卫生—呼吸系统]