本文選題：敗血癥 + 氣單胞菌　； 參考：《中國(guó)抗生素雜志》2017年07期

【摘要】：目的加強(qiáng)對(duì)氣單胞菌敗血癥的認(rèn)識(shí),分析90例慢性肝病患者氣單胞菌敗血癥的臨床及病原學(xué)特點(diǎn)、耐藥性及治療轉(zhuǎn)歸。方法查閱2001—2015年住院的肝病患者氣單胞菌敗血癥病例,回顧性分析其臨床特征、病原藥物敏感性及轉(zhuǎn)歸。結(jié)果90例氣單胞菌敗血癥中57.78%為院內(nèi)感染,94.44%患者的基礎(chǔ)疾病為肝硬化。臨床表現(xiàn)均有發(fā)熱,50(55.56%)例伴有寒戰(zhàn),高度乏力37(41.11%)例,黃疸加重30(33.33%)例,14(15.56%)例同時(shí)存在腹痛及腹瀉,13(14.44%)例發(fā)生感染性休克。感染菌種以嗜水氣單胞菌(47.78%)占優(yōu)勢(shì),16.67%的患者有廣譜抗生素應(yīng)用史,26.67%的患者有抑酸藥物應(yīng)用史。氣單胞菌對(duì)氨芐西林(96.50%)、頭孢唑林(95.60%)、亞胺培南(69.40%)、替卡西林(42.10%)、哌拉西林(34.90%)、復(fù)方磺胺甲VA唑(32.70%)和美羅培南(30.60%)的不敏感率較高。按藥敏及時(shí)抗感染治療,治愈率和好轉(zhuǎn)率分別為66.67%和21.11%。結(jié)論氣單胞菌敗血癥易發(fā)生于肝硬化患者,以嗜水氣單胞菌為主,有其臨床特征及病原學(xué)特點(diǎn),應(yīng)高度重視,及時(shí)針對(duì)性抗菌藥物治療。
[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.
【作者單位】： 解放軍第三0二醫(yī)院干部醫(yī)療保健中心;解放軍第三0二醫(yī)院臨床檢驗(yàn)醫(yī)學(xué)中心;
【基金】：首都市民健康培育項(xiàng)目(No.Z151100003915151)
【分類號(hào)】：R515.3;R575

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