老年人鲍曼不动杆菌肺部感染115例临床分析

The feature of pulmonary infection caused by Acinetobacter baumannii in old patients

目的了解老年鲍曼不动杆菌肺部感染的临床特点。方法分析115例老年鲍曼不动杆菌肺部感染患者的症状、体征、肺部影像学改变、痰细菌培养、药敏实验及治疗转归等。结果老年鲍曼不动杆菌肺部感染多于基础疾病的危重期起病。临床症状和体征缺乏特征性。肺部X线影像学变化以小片状浸润影多见（占82％）。痰培养鲍曼不动杆菌占检出革兰氏阴性杆菌的11．9％；鲍曼不动杆菌对常用抗生素的耐药率为5．4％ ～95．1％。患者住院病死率为20．9％。结论临床上应警惕并重视鲍曼不动杆菌所引起的老年肺部感染。对老年鲍曼不动杆菌肺部感染患者须注意病原菌及其耐药率的监测。

Objective To investigate the clinical characteristics of pulmonary infection caused by Acinetobacter baumannii. Methods 115 cases of old patients with pulmonary infection due to Acinetobacter baumannli were reviewed, and the symptoms and physical signs and X-ray imaging of chest and sputum culture and drug sensitivity test and the effect of the treatment studied. Result Pulmonary infection caused by Acinetobacter baumarmii in old patients were mostly seen at critical stage of the basic disease. There were nonspecific symptoms and physical signs. Most X-ray imaging of chest show small opacity （82%）. Among the 488 strains of Gram-negative bacteria isolated from sputum culture, 115 were Acinetobacter baumannii （11. 89% ） ;The Acinetobacter strains were identified through sputum culture to be resistant to antibiotics, and the drug resistance rate were ranging from 5.4% to 95.1%, and the case fatality was 20.9%. Conclusion Pulmonary infection caused by Acinetobacter baumarmii in old patients must be taken into account. And identification and monitor of its antibiotic resistance should be intensified.