老年患者医院获得性鲍氏不动杆菌性肺炎临床特点及药敏分析

Clinical Features of Elderly Patients with Hospital-acquired Pneumonia Caused by Acinetobacter baumannii and Drug Sensitivity Analysis

目的探讨老年患者医院获得性鲍氏不动杆菌性肺炎的临床特点以及对抗菌药物的敏感情况。方法回顾性地分析40例老年患者医院获得性鲍氏不动杆菌性肺炎的临床资料,包括一般情况、基础疾病、临床症状及体征、X线检查结果、实验室检查结果、机械通气实施情况、药敏结果及病情转归。结果老年患者由于自身免疫能力下降,患医院获得性鲍氏不动杆菌性肺炎后发热占65.0%,白细胞计数升高占32.5%,主要以中性粒细胞百分比升高为主(75.0%);对常规检测的抗菌药物均耐药的鲍氏不动杆菌占一定比例(25.6%),对抗菌药物敏感的鲍氏不动杆菌中其较敏感的抗菌药物依次为:亚胺培南35例(54.7%),阿米卡星34例(53.1%),左氧氟沙星31例(48.4%),多黏菌素B 26例(40.6%),头孢他啶26例(40.6%),环丙沙星26例(40.6%)。结论对于老年患者医院获得性鲍氏不动杆菌性肺炎,可联用碳青酶烯类(亚胺培南或美罗培南)和头孢哌酮/舒巴坦。

OBJECTIVE To explore the clinical features of hospital-acquired pneumonia（HAP） caused by Acinetobacter baumannii.and the sensitivity to antibiotics.METHODS The clinical data of 40 elderly patients with HAP caused by A.baumannii were analyzed retrospectively,including the general condition,underlying disease,clinical symptoms and signs,X-ray findings,laboratory test results,implementation of mechanical ventilation,drug sensitivity and prognosis.RESULTS Owing to decreased immunity of their own,among the elderly patients with HAP caused by A.baumannii,fever accounted 65.0%,WBC accounted 32.5%,in which the increase in neutrophils with 75% was predominant.25.6% of A.baumannii strains in this research showed drug resistance to all the antibiotics used for the routine test.The antibiotics,to which A.baumannii was more sensitive,were respectively as the followings： imipenem（54.7%）,amikacin（53.1%）,levofloxacin（48.4%）,polymyxin B（40.6%）,ceftazidime（40.6%） and ciprofloxacin（40.6%）.CONCLUSION Carbapenems（imipenem or meropenem） with cefperazone/sulbactam can be used for the elderly patients with HAP caused by A.baumannii.