本文選題：老年臥床患者　切入點(diǎn)：肺部感染　出處：《中華醫(yī)院感染學(xué)雜志》2017年12期

【摘要】：目的調(diào)查長期臥床老年患者繼發(fā)鮑氏不動(dòng)桿菌肺部感染的臨床特點(diǎn),探討其預(yù)防對(duì)策。方法回顧性分析2014年3月-2016年3月間103例長期臥床老年患者繼發(fā)鮑氏不動(dòng)桿菌肺部感染的臨床資料和藥敏試驗(yàn)結(jié)果,同時(shí),選擇同期在醫(yī)院住院未發(fā)生肺部感染的老年長期臥床患者100例。結(jié)果 103例長期臥床老年患者繼發(fā)鮑氏不動(dòng)桿菌肺部感染中,以慢性阻塞性肺疾病最為常見,占32.0%;長期臥床老年患者繼發(fā)肺部鮑氏不動(dòng)桿菌感染與年齡、住院時(shí)間、吸煙史、自主咳嗽能力、吞咽困難和意識(shí)障礙等因素有關(guān);年齡、自主咳嗽能力、意識(shí)障礙是老年長期臥床患者繼發(fā)肺部鮑氏不動(dòng)桿菌感染的獨(dú)立危險(xiǎn)因素(P0.05);103株鮑氏不動(dòng)桿菌對(duì)氨芐西林、哌拉西林的耐藥率90.0%,對(duì)替加環(huán)素、環(huán)丙沙星較為敏感,耐藥率40.0%,對(duì)亞胺培南最為敏感,耐藥率為18.4%。結(jié)論年齡、自主咳嗽能力及意識(shí)障礙與長期臥床老年患者繼發(fā)肺部鮑氏不動(dòng)桿菌感染密切相關(guān),臨床應(yīng)根據(jù)藥敏試驗(yàn)結(jié)果及相關(guān)危險(xiǎn)因素采取針對(duì)性措施,避免肺部鮑氏不動(dòng)桿菌感染病情的加重。
[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.
【作者單位】： 鄭州大學(xué)附屬洛陽市中心醫(yī)院老年科;
【分類號(hào)】：R563.1

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本文編號(hào)：1696558