肝病患者气单胞菌败血症90例临床特征及转归

发布时间：2018-05-02 10:24

本文选题：败血症 + 气单胞菌　；参考：《中国抗生素杂志》2017年07期

【摘要】：目的加强对气单胞菌败血症的认识,分析90例慢性肝病患者气单胞菌败血症的临床及病原学特点、耐药性及治疗转归。方法查阅2001—2015年住院的肝病患者气单胞菌败血症病例,回顾性分析其临床特征、病原药物敏感性及转归。结果90例气单胞菌败血症中57.78%为院内感染,94.44%患者的基础疾病为肝硬化。临床表现均有发热,50(55.56%)例伴有寒战,高度乏力37(41.11%)例,黄疸加重30(33.33%)例,14(15.56%)例同时存在腹痛及腹泻,13(14.44%)例发生感染性休克。感染菌种以嗜水气单胞菌(47.78%)占优势,16.67%的患者有广谱抗生素应用史,26.67%的患者有抑酸药物应用史。气单胞菌对氨苄西林(96.50%)、头孢唑林(95.60%)、亚胺培南(69.40%)、替卡西林(42.10%)、哌拉西林(34.90%)、复方磺胺甲VA唑(32.70%)和美罗培南(30.60%)的不敏感率较高。按药敏及时抗感染治疗,治愈率和好转率分别为66.67%和21.11%。结论气单胞菌败血症易发生于肝硬化患者,以嗜水气单胞菌为主,有其临床特征及病原学特点,应高度重视,及时针对性抗菌药物治疗。
[Abstract]:Objective to strengthen the understanding of Aeromonas septicemia and analyze the clinical and etiological characteristics, drug resistance and therapeutic outcome of 90 patients with chronic liver disease. Methods from 2001 to 2015, the patients with Aeromonas septicemia in patients with liver disease were retrospectively analyzed. Results among 90 patients with Aeromonas septicemia, 57.78% of them were patients with hospital infection and 94.44% had cirrhosis. The clinical manifestations included fever 5055.56) accompanied by shivering, high fatigue 3741.11), jaundice aggravated 300.333.33) and abdominal pain and diarrhea 1314.4444). The most common infection bacteria were Aeromonas hydrophila (47.78). 16.67% of the patients had a history of broad-spectrum antibiotic use and 26.67% had a history of anti-acid drugs. The insensitivity rates of Aeromonas to ampicillin, cefazolin, imipenem, ticacillin, piperacillin, compound sulfamethoxazole and meropenem were higher than those of ampicillin, cefazolin, imipenem, ticacillin, piperacillin, compound sulfamethoxazole 32.70 and meropenem 30.60. The cure rate and improvement rate were 66.67% and 21.11% respectively. Conclusion Aeromonas septicemia is easy to occur in patients with liver cirrhosis, mainly Aeromonas hydrophila, which has its clinical and etiological characteristics.
【作者单位】：解放军第三0二医院干部医疗保健中心;解放军第三0二医院临床检验医学中心;
【基金】：首都市民健康培育项目(No.Z151100003915151)
【分类号】：R515.3;R575

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