鲍氏不动杆菌致慢性阻塞性肺疾病患者肺部感染临床及耐药性分析

Antibiotic Resistance and Clinical Characteristics of Pulmonary Infection Induced by Acinetobacter baumannii in Patients with Chronic Obstructive Pulmonary Disease

目的探讨慢性阻塞性肺疾病(COPD)患者肺部鲍氏不动杆菌感染的临床特点和耐药情况。方法对78例COPD患者肺部鲍氏不动杆菌感染的临床表现及药敏情况进行回顾分析。结果药物敏感性测定提示该菌对头孢哌酮/舒巴坦耐药率最低,为14.9%,其次为亚胺培南和美罗培南,分别是24.8%和28.2%;对氨苄西林、头孢他啶、头孢吡肟、哌拉西林、左氧氟沙星、莫西沙星、阿米卡星、氨曲南和替卡西林/克拉维酸有较高耐药率,为48.5%～74.8%。结论COPD患者肺部鲍氏不动杆菌感染与年老体弱,广谱抗菌药物及激素应用、呼吸道侵入性操作及呼吸机使用有关,临床表现无特异性,耐药严重,病死率高,应注意预防。

OBJECTIVE To analyze the antibiotic resistance and the clinical characteristics of pulmonary infection induced by Acinetobacter baumannii in patients with chronic obstructive pulmonary disease（COPD）.METHODS The clinical data and antibiotic susceptibility of 78 cases of pulmonary infection in patients with COPD were retrospected.RESULTS In all isolates of A.baumannii,the resistant rate of A.baumannii to cefoperazone/sulbactam was the lowest（14.9 %）,followed by imipenem（24.8%）,meropenem（28.2%）,but higher for ampicillin,ceftazidime,cefepime,piperacillin,levofloxacin,moxifloxacin,amikacin,aztreonam,and ticarcillin/clavulanic acid（48.5-74.8%）.CONCLUSIONS A.baumannii pulmonary infection in patients with COPD is related with the elderly,weakling,the application of broad-spectrum antibiotic and glucocorticoid,the invasive operation on respiratory tract,and the use of respirator.It has non-specific clinical manifestation,high resistant rate and high mortality,we should pay attention to prophylaxis.