鲍氏不动杆菌血流感染患者抗感染治疗分析
发布时间:2017-12-31 05:27
本文关键词:鲍氏不动杆菌血流感染患者抗感染治疗分析 出处:《中华医院感染学杂志》2016年14期 论文类型:期刊论文
【摘要】:目的分析鲍氏不动杆菌血流感染的临床特征和抗感染治疗情况,探讨鲍氏不动杆菌血流感染的防治方法,以提高临床疗效。方法分析医院2012年5月-2015年6月确诊为鲍氏不动杆菌血流感染病例共45例,根据患者抗菌药物的应用分为碳青霉烯类治疗组、头孢哌酮/舒巴坦治疗组、碳青霉烯类-头孢哌酮/舒巴坦序贯治疗组、哌拉西林/他唑巴坦组和其他抗菌药物单药治疗组,分析患者临床特征及抗感染治疗结果。结果鲍氏不动杆菌血流感染患者抗感染治疗有效组在合并重症肺炎、APACHEⅡ评分、深静脉置管、有创机械通气、入住ICU、不恰当经验性治疗和细菌耐药性等方面与无效组相比,差异有统计学意义(P0.05);碳青霉烯组、头孢哌酮/舒巴坦组、碳青霉烯类-头孢哌酮/舒巴坦组、哌拉西林/他唑巴坦组和其他治疗组的抗感染治疗有效比例分别为55.6%、68.8%、50.0%、85.7%、100%;患者预后与感染的鲍氏不动杆菌耐药情况密切相关,治疗无效组多重耐药菌和泛耐药菌构成比为91.7%,而有效组仅为39.4%,两组间差异具有统计学意义(P0.05);各治疗组的抗感染治疗有效率与感染耐药菌的比例正相关。结论重症合并有重症肺炎等基础疾病的患者发生鲍氏不动杆菌血流感染的抗感染治疗预后较差,深静脉置管或有创机械通气、入住ICU、不恰当经验性治疗、多重耐药菌为其高危因素,使用碳青霉烯类或头孢哌酮/舒巴坦或二者序贯联合其他药物治疗对多重耐药菌感染有一定的疗效。
[Abstract]:Objective to analyze the clinical characteristics and anti-infection treatment of Acinetobacter baumannii blood stream infection, and to explore the prevention and treatment of the blood flow infection of Acinetobacter baumannii. Methods from May 2012 to June 2015, 45 patients with Acinetobacter baumannii blood stream infection were analyzed. According to the application of antimicrobial agents, patients were divided into carbapenem treatment group, cefoperazone / sulbactam treatment group, carbapene-cefoperazone / sulbactam sequential treatment group. Piperacillin / tazobactam group and other antimicrobial single-drug treatment group, the clinical characteristics and anti-infection treatment results were analyzed. Results the effective group of anti-infection treatment for patients with blood stream infection of Acinetobacter baumannii was complicated with severe pneumonia. The scores of APACHE 鈪,
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