不动杆菌和铜绿假单胞菌肺炎46例分析

46-case study of pneumonia caused by acinetobater and P. aeruginosa.

目的调查不动杆菌和铜绿假单胞菌肺炎的临床特点及细菌耐药。方法回顾性分析46例不动杆菌和铜绿假单胞菌引起的肺炎的临床资料和细菌耐药。结果这两种细菌引起的肺炎无特异性。两者基础疾病,主要为慢性阻塞性肺疾病(COPD),其次为恶性肿瘤、心功能不全、脑中风及支气管扩张。两者主要症状是发热(73%),咳嗽(92%),氯急。胸部X线表现肺部间质病变13例。药敏结果显示出这两种细菌多重耐药,但阿米卡星,哌拉西林、环丙沙星、诺氟沙星、头孢曲松、头孢哌酮为较敏感的抗生素。结论不动杆菌和铜绿假单胞菌引起的肺炎之间无特异性临床特点。两菌肺炎患者的气急病人因以控制感染为主,诊断依靠病原学并结合临床及X线检查,治疗应根据药敏并联合应用抗生素。

Investigate the clinical features and antimicrobial resistance of the pneumonia caused by acinetobater and P. aeruginosa. Methods The study analyzed the clinical data and antimicrobial resistance of 46 cases of pneumonia caused by acinetobater and P. aeruginosa. The data included ages, symptoms, signs, underling diseases, sputum culture, X-ray findings and drug sensitivity against the two types of bacterias. Results The clinical features were lack of specificity. There were no specificity in the sequence of the underlining disease. Most were COPD （26 cases）, followed by tumour, heart failure, stroke, and bronchiectasis. The chief symptoms were fever （73%） and productive cough （95%）. The antimicrobial tests showed that the two bacterias were muhiresistant to antibiotics, but Amikacin Piperacillin Nofloxacin. Ceftriaxone. Cefoperone were sensitive. Conclusion The pneumonia caused by acinetobater and P. aeruginosa showed no specific clinical manifestation. The diagnosis should be made according to bacteriologic examination combined with clinical and X-ray manifestation. Combining antibiotics therapy was recommanded according to antimicrobial sensitivity test.