本文關(guān)鍵詞：鮑氏不動(dòng)桿菌血流感染患者抗感染治療分析　出處：《中華醫(yī)院感染學(xué)雜志》2016年14期 　論文類型：期刊論文

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【摘要】：目的分析鮑氏不動(dòng)桿菌血流感染的臨床特征和抗感染治療情況,探討鮑氏不動(dòng)桿菌血流感染的防治方法,以提高臨床療效。方法分析醫(yī)院2012年5月-2015年6月確診為鮑氏不動(dòng)桿菌血流感染病例共45例,根據(jù)患者抗菌藥物的應(yīng)用分為碳青霉烯類治療組、頭孢哌酮/舒巴坦治療組、碳青霉烯類-頭孢哌酮/舒巴坦序貫治療組、哌拉西林/他唑巴坦組和其他抗菌藥物單藥治療組,分析患者臨床特征及抗感染治療結(jié)果。結(jié)果鮑氏不動(dòng)桿菌血流感染患者抗感染治療有效組在合并重癥肺炎、APACHEⅡ評(píng)分、深靜脈置管、有創(chuàng)機(jī)械通氣、入住ICU、不恰當(dāng)經(jīng)驗(yàn)性治療和細(xì)菌耐藥性等方面與無效組相比,差異有統(tǒng)計(jì)學(xué)意義(P0.05);碳青霉烯組、頭孢哌酮/舒巴坦組、碳青霉烯類-頭孢哌酮/舒巴坦組、哌拉西林/他唑巴坦組和其他治療組的抗感染治療有效比例分別為55.6%、68.8%、50.0%、85.7%、100%;患者預(yù)后與感染的鮑氏不動(dòng)桿菌耐藥情況密切相關(guān),治療無效組多重耐藥菌和泛耐藥菌構(gòu)成比為91.7%,而有效組僅為39.4%,兩組間差異具有統(tǒng)計(jì)學(xué)意義(P0.05);各治療組的抗感染治療有效率與感染耐藥菌的比例正相關(guān)。結(jié)論重癥合并有重癥肺炎等基礎(chǔ)疾病的患者發(fā)生鮑氏不動(dòng)桿菌血流感染的抗感染治療預(yù)后較差,深靜脈置管或有創(chuàng)機(jī)械通氣、入住ICU、不恰當(dāng)經(jīng)驗(yàn)性治療、多重耐藥菌為其高危因素,使用碳青霉烯類或頭孢哌酮/舒巴坦或二者序貫聯(lián)合其他藥物治療對(duì)多重耐藥菌感染有一定的療效。
[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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