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医院下呼吸道鲍氏不动杆菌感染的临床特点及相关因素分析

Clinical characteristics and related factors for lower respiratory tract infection caused by Acinetobacter baumannii
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摘要 目的分析医院下呼吸道鲍氏不动杆菌感染的临床特点及相关因素,并探究其预防措施。方法回顾性分析2015年7月-2017年7月医院收治的下呼吸道鲍氏不动杆菌感染患者90例为感染组,并选取同期住院但未发生感染的患者90例为对照组,分析感染患者病原菌耐药性,并归纳患者医院下呼吸道鲍氏不动杆菌感染的相关因素。结果下呼吸道感染患者合并其他感染以中枢神经系统感染、血流感染、泌尿系统感染为主;鲍氏不动杆菌对庆大霉素、左氧氟沙星、哌拉西林/他唑巴坦等药物耐药率〉80%,美罗培南、头孢他啶、亚胺培南等药物耐药率均〉90%,仅对米诺环素和替加环素较敏感;机械通气、入住ICU时间、联合使用抗菌药物是患者医院下呼吸道鲍氏不动杆菌感染的相关因素(P〈0.05)。结论针对相关因素并结合鲍氏不动杆菌感染的特点及耐药性采取相应预防措施,可尽最大程度避免下呼吸道感染的发生,提高临床医疗质量。 OBJECTIVE To investigate the clinical characteristics of the lower respiratory tract infection caused by Acinetobacter baumannii,analyze the related factors and put forward the prevention measures.METHODS Totally 90 patients who had A.baumannii lower respiratory tract infection and were treated in the hospital from Jul 2015 to Jul 2017 were chosen as the infection group,and 90 patients who were hospitalized during the same period but did not have infection were chosen as the control group.The drug resistance of pathogens isolated from the patients with the infection was observed,and the related factors for the lower respiratory tract infection were summarized.RESULTS The patients who were complicated with central nervous system infection,bloodstream infection and urinary tract infection were dominant among the patients with lower respiratory tract infection.The drug resistance rates of the A.baumannii strains to gentamicin,levofloxacin and piperacillin-tazobactam were more than 80%,the drug resistance rates to meropenem,ceftazidime and imipenem were more than 90%,and the strains were only susceptible to minocycline and tigecycline.The mechanical ventilation,length of ICU stay and combined use of antibiotics were the related factors for the lower respiratory tract infection caused by the A.baumannii(P〈0.05).CONCLUSIONIt is necessary to take targeted prevention measures according to the related factors and characteristics of the A.baumannii infection so as to prevent the lower respiratory tract infection and improve the clinical medical quality.
作者 徐武成 陈黎燕 葛敏捷 钟永红 陈青青 XU Wu-cheng, CHEN Li-yan, GE Min-jie, ZHONG Yong-hong, CHEN Qing-qing (The First People's Hospital of Yuhang District, Hangzhou, Zhejiang 311100, China)
出处 《中华医院感染学杂志》 CSCD 北大核心 2018年第20期3056-3059,共4页 Chinese Journal of Nosocomiology
基金 杭州市科技发展计划基金资助项目(20140633B57)
关键词 医院感染 鲍氏不动杆菌 下呼吸道感染 相关因素 耐药性 Nosocomial infection Acinetobacter baumannii Lower respiratory tract infection Related factorDrug resistance
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