泛耐药鲍曼不动杆菌菌血症的临床特点及预后

发布时间：2018-03-09 18:59

  本文选题：泛耐药鲍曼不动杆菌　切入点：菌血症　出处：《中国呼吸与危重监护杂志》2017年05期 　论文类型：期刊论文

【摘要】：目的对重症监护病房泛耐药鲍曼不动杆菌菌血症的临床特点及预后进行总结。方法回顾性研究2012年1月至2015年12月31日北京大学第一院呼吸监护室的鲍曼不动杆菌菌血症患者,收集患者人口学特点、临床资料、3d及14 d的预后。结果纳入8例患者,平均年龄(62.4±18.0)岁,男3例,女5例。所有患者均患有基础疾病,6例为免疫抑制患者,7例患者发病前2周内接受含有β内酰胺酶抑制剂的复合制剂或碳青霉烯类抗菌药物,6例接受机械通气,肺脏是主要病源。菌种鉴定均为泛耐药鲍曼不动杆菌。患病48h内平均急性生理与慢性健康状况Ⅱ(APACHEⅡ)评分为(28.3±7.5)分,C反应蛋白(18.2~231.0mg/L)和降钙素原(0.1~25.0ng/ml)个体差异较大。3d死亡率为4/8,均为入APACHEⅡ25分的患者;14d死亡率为6/8,PCT0.5ng/ml的患者均死亡。结论泛耐药鲍曼不动杆菌菌血症患者14d的预后和疾病严重程度及降钙素原升高有关。对于APACHEⅡ25分、降钙素原升高、之前接受机械通气的高度可疑患者应考虑在血培养结果回报前抢先治疗。
[Abstract]:Objective to summarize the clinical characteristics and prognosis of pandrug-resistant Acinetobacter baumannii in intensive care unit (ICU). Methods A retrospective study was conducted on patients with Acinetobacter baumannii from January 2012 to December 31st 2015 in the Respiratory Care Unit of Peking University. The demographic characteristics of the patients and the prognosis of 3 days and 14 days of clinical data were collected. Results the mean age of 8 patients was 62.4 卤18.0 years (male 3). All the patients had basic diseases. Six patients were immunosuppressive patients. Seven patients received mechanical ventilation with 尾 lactamase inhibitors or carbapenem antibiotics within 2 weeks before the onset of the disease. The average acute physiological and chronic health status 鈪，

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