基层医学论坛
基層醫學論罈
기층의학론단
PUBLIC MEDICAL FORUM MAGAZINE
2014年
28期
3748-3750
,共3页
重症医学科%老年患者%机械通气%鲍曼不动杆菌%耐药
重癥醫學科%老年患者%機械通氣%鮑曼不動桿菌%耐藥
중증의학과%노년환자%궤계통기%포만불동간균%내약
ICU%Elderly patients%Mechanical ventilation%Acinetobacter%Baumannii%Extensively drug-resistant
目的:分析老年患者机械通气鲍曼不动杆菌感染和耐药情况,为本地区老年患者鲍曼不动杆菌感染治疗及预防提供理论依据。方法分析我院重症医学科老年患者机械通气感染鲍曼不动杆菌临床常见抗生素药敏培养结果,对治疗及转归进行评价。结果12个月内入住重症医学科的老年患者下呼吸道分泌物培养出鲍曼不动杆菌共108例,所有菌株对临床常用药物耐药非常严重,药敏结果显示本地区鲍曼不动杆菌对临床常见抗生素耐药率大部分达70.00%以上,对青霉素类和二、三代头孢菌素全部表现为广泛耐药或者全耐药。108例患者中70例治疗结束后随访符合临床治愈,38例在治疗结束后随访临床无效,其中30例患者死亡。结论本地区老年患者感染鲍曼不动杆菌耐药率非常高,临床治疗应根据药敏结果选择适宜抗生素,并采取有效的预防隔离措施。
目的:分析老年患者機械通氣鮑曼不動桿菌感染和耐藥情況,為本地區老年患者鮑曼不動桿菌感染治療及預防提供理論依據。方法分析我院重癥醫學科老年患者機械通氣感染鮑曼不動桿菌臨床常見抗生素藥敏培養結果,對治療及轉歸進行評價。結果12箇月內入住重癥醫學科的老年患者下呼吸道分泌物培養齣鮑曼不動桿菌共108例,所有菌株對臨床常用藥物耐藥非常嚴重,藥敏結果顯示本地區鮑曼不動桿菌對臨床常見抗生素耐藥率大部分達70.00%以上,對青黴素類和二、三代頭孢菌素全部錶現為廣汎耐藥或者全耐藥。108例患者中70例治療結束後隨訪符閤臨床治愈,38例在治療結束後隨訪臨床無效,其中30例患者死亡。結論本地區老年患者感染鮑曼不動桿菌耐藥率非常高,臨床治療應根據藥敏結果選擇適宜抗生素,併採取有效的預防隔離措施。
목적:분석노년환자궤계통기포만불동간균감염화내약정황,위본지구노년환자포만불동간균감염치료급예방제공이론의거。방법분석아원중증의학과노년환자궤계통기감염포만불동간균림상상견항생소약민배양결과,대치료급전귀진행평개。결과12개월내입주중증의학과적노년환자하호흡도분비물배양출포만불동간균공108례,소유균주대림상상용약물내약비상엄중,약민결과현시본지구포만불동간균대림상상견항생소내약솔대부분체70.00%이상,대청매소류화이、삼대두포균소전부표현위엄범내약혹자전내약。108례환자중70례치료결속후수방부합림상치유,38례재치료결속후수방림상무효,기중30례환자사망。결론본지구노년환자감염포만불동간균내약솔비상고,림상치료응근거약민결과선택괄의항생소,병채취유효적예방격리조시。
Objective Learn Tangshan acinetobacter baumannii infection and drug resistance in elderly patients with mechanical ventilation,For elderly patients with acinetobacter baumannii infection in our region provide theoretical basis for treatment and prevention. Method Analyze drug resistance for elderly patients with mechanical ventilation acinetobacter baumannii to common antibiotics susceptibility to cultivate clinical results. Results In a period of 12 months staying with ICU patients, we cultured 108 cases of acinetobacter baumannii from lower respiratory tract secretions. Clinical drug resistance is very serious for all strains. The results of cultivation show that resistance rates are very high (more than 70.00%),to penicillin and all second and third generation cephalosporin antibiotic showed extensive drug resistance or full resistance, high drug resistance to imipenem and meropenem, sensitivity is high only for polymyxin . Acinetobacter baumannii is in lower detection rate in spring and summer than autumn and winter. Among 108 patients, 70 cases were cured or improved,38 cases of ineffective treatment, 30 cases died. Conclusion Resistant to Acinetobacter baumannii infection rate is very high for elderly patients in the region. And it is very difficult to treat these bacteria. Clinical treatment should be based on a reasonable choice of the region antibiotic susceptibility results, and take effective measures to prevent isolation.