长期卧床老年患者继发鲍氏不动杆菌肺部感染的临床特点及预防对策

发布时间：2018-04-01 17:20

本文选题：老年卧床患者　切入点：肺部感染　出处：《中华医院感染学杂志》2017年12期

【摘要】：目的调查长期卧床老年患者继发鲍氏不动杆菌肺部感染的临床特点,探讨其预防对策。方法回顾性分析2014年3月-2016年3月间103例长期卧床老年患者继发鲍氏不动杆菌肺部感染的临床资料和药敏试验结果,同时,选择同期在医院住院未发生肺部感染的老年长期卧床患者100例。结果 103例长期卧床老年患者继发鲍氏不动杆菌肺部感染中,以慢性阻塞性肺疾病最为常见,占32.0%;长期卧床老年患者继发肺部鲍氏不动杆菌感染与年龄、住院时间、吸烟史、自主咳嗽能力、吞咽困难和意识障碍等因素有关;年龄、自主咳嗽能力、意识障碍是老年长期卧床患者继发肺部鲍氏不动杆菌感染的独立危险因素(P0.05);103株鲍氏不动杆菌对氨苄西林、哌拉西林的耐药率90.0%,对替加环素、环丙沙星较为敏感,耐药率40.0%,对亚胺培南最为敏感,耐药率为18.4%。结论年龄、自主咳嗽能力及意识障碍与长期卧床老年患者继发肺部鲍氏不动杆菌感染密切相关,临床应根据药敏试验结果及相关危险因素采取针对性措施,避免肺部鲍氏不动杆菌感染病情的加重。
[Abstract]:Objective to investigate the clinical characteristics of secondary pulmonary infection of Acinetobacter baumannii in the elderly patients who were in bed for a long time. Methods the clinical data and drug sensitivity test results of 103 elderly patients with secondary pulmonary infection of Acinetobacter baumannii from March 2014 to March 2016 were analyzed retrospectively. A total of 100 elderly bedridden patients without pulmonary infection in hospital were selected. Results chronic obstructive pulmonary disease (COPD) was the most common in 103 elderly patients with secondary pulmonary infection of Acinetobacter baumannii. Secondary infection of Acinetobacter baumannii in lung was related to age, length of stay in hospital, history of smoking, ability of spontaneous cough, dysphagia and disturbance of consciousness, etc. Disturbance of consciousness is an independent risk factor for secondary infection of Acinetobacter baumannii in the lungs of elderly patients with long-term bed rest. 103 strains of Acinetobacter baumannii are resistant to ampicillin and piperacillin, and sensitive to tegacycline and ciprofloxacin. The drug resistance rate was 40. 0%, which was most sensitive to imipenem, and the drug resistance rate was 18. 4. Conclusion Age, ability of spontaneous cough and disturbance of consciousness are closely related to the secondary infection of Acinetobacter baumannii in the lung of the elderly patients who have been in bed for a long time. In order to avoid the aggravation of acinetobacter baumannii infection in lung, clinical measures should be taken according to the results of drug sensitivity test and related risk factors.
【作者单位】：郑州大学附属洛阳市中心医院老年科;
【分类号】：R563.1

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