肺部铜绿假单胞菌和鲍曼不动杆菌感染者临床疗效评价

Evaluation of clinical effects for patients with pulmonary infections of Pseudomonas aeruginosa and Acinetobacter baumannii

目的了解不同治疗方案对铜绿假单胞菌和鲍曼不动杆菌肺部感染患者的疗效评价,用以证明循证治疗的重要性。方法分析2005年7月至2009年3月来自我院住院并感染铜绿假单胞菌和鲍曼不动杆菌患者的46例,作患者痰标本的培养和药敏试验,根据试验回顾调查其病例,分组比较不同治疗方案的肺部感染患者的不同转归百分率,并进行χ2检验。结果不同治疗方法在治疗铜绿假单胞菌和鲍曼不动杆菌感染时循证用药组与经验用药组治疗效果有统计学意义,即有显著差异;联合用药组与单独用药组治疗效果有统计学意义,即有显著差异;亚胺培南耐药与否的治疗效果的差别有统计学意义,即有显著差异。结论治疗多重耐药的铜绿假单胞菌和鲍曼不动杆菌感染特别是产金属β-内酰胺酶者宜采用联合用药结合支持疗法。

Objective To comprehend the different treatment to pulmonary infections of Pseudomonas aeruginosa and Acinetobacter baumannii in patients to demonstrate the importance of evidence-based treatment.Methods Forty-six hospitalized patients with infections of Pseudomonas aeruginosa and Acinetobacter baumannii were analysed from July 2005 to March 2009 in this hospital,sputum culture and sensitivity test were done. The case of recall was reviewed according to testing results,grouping by different treatment options of lung infection. The ratio of the patients with different prognosis was analyzed by χ^2 test. Results Significant difference was found in the effect between groups treated by classical treatment or evidence-based treatment ,between groups treated by single drug or combination treatment,between imipenem-resistant group and imipenem-sensitive group. Conclusion The treatment of multi-drug resistant Pseudomonas aeruginosa and Acinetobacter baumannii infections,in particular with production of metal β-lactamases,should be treated with combination therapy.