泛耐药鲍曼不动杆菌感染的高危因素及临床治疗方案探讨

发布时间：2018-09-04 16:39

【摘要】：目的:探讨泛耐药鲍曼不动杆菌感染的高危因素、治疗方案及临床效果。方法:回顾性分析125例确诊为Ab感染患者的临床资料,总结相关高危因素,对比分析不同临床治疗方案取得的效果。结果:本组125例患者,泛耐药Ab共38例(占30.4%),与合并糖尿病、脑血管意外、低白蛋白血症、住院时间较长、有侵入性操作及使用碳青霉烯类和合用3种及以上抗菌药物有关,是否应用替加环素和舒巴坦复合制剂,组间治疗有效率和细菌清除率比较,差异并不显著(P0.05);其中替加环素联合碳青霉烯的治疗有效率(40.0%)和细菌清除率(20.0%)均低于联合舒巴坦(51.7%、69.0%),比较差异显著(P0.05);舒巴坦联合替加环素、碳青霉烯和多西环素,组间细菌清除率比较,差异较为显著(P0.05)。结论:泛耐药Ab感染的发生与多种因素有关,在药敏试验基础上合理用药,可提高临床治疗效果。
[Abstract]:Objective: to investigate the high risk factors, treatment plan and clinical effect of pan-resistant Acinetobacter baumannii infection. Methods: the clinical data of 125 patients with Ab infection were analyzed retrospectively. Results: among the 125 patients, 38 (30.4%) were pan-resistant Ab, which were associated with diabetes mellitus, cerebrovascular accident, hypoalbuminemia, long hospital stay, invasive operation and use of carbapenem and combined with 3 or more antimicrobial agents. Whether tigicycline and sulbactam were used in combination, the efficacy of treatment and bacterial clearance were compared between the groups. The effective rate (40.0%) and bacterial clearance rate (20.0%) of tegicycline combined with carbapenem were significantly lower than that of sulbactam (51.7%) (P0.05), and sulbactam combined with tegacyclin, carbapenem and doxycycline were significantly lower than that of sulbactam (P 0.05). There was significant difference in bacterial clearance rate between groups (P0.05). Conclusion: the incidence of pan-resistant Ab infection is related to many factors. Rational use of drugs on the basis of drug sensitivity test can improve the clinical therapeutic effect.
【作者单位】：重庆市万州区第五人民医院;
【分类号】：R446.5

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