100例铜绿假单胞菌致医院获得性肺炎患者30d死亡危险因素分析

Risk factors for 30-day mortality in 100 patients with Paeudomonas Aeruginosa-induced hospital acquired pneumonia

目的探讨铜绿假单胞菌致医院获得性肺炎30d死亡危险因素,为初始经验性治疗提供参考。方法回顾性调查我院重症监护室2009年1月-2011年10月100例铜绿假单胞菌致医院获得性肺炎患者临床信息,对30d死亡危险因素进行分析,对下呼吸道标本分离的铜绿假单胞菌进行药敏试验。结果高APACHEⅡ评分(P=0.00)和病原菌未覆盖(P=0.01)是医院获得性肺炎30d死亡的危险因素。铜绿假单胞菌对头孢他啶、环丙沙星、头孢吡肟和哌拉西林他唑巴坦耐药率较低,分别为17%、19%、21%和26%。结论高APACHEⅡ评分,病原菌未覆盖是30d死亡危险因素。头孢他啶、环丙沙星、头孢吡肟和哌拉西林他唑巴坦保持着良好的抗铜绿假单胞菌活性。

Objective To provide the reference for initial experience-based treatment of Peudomonas aeruginosa-induced hospital acquired pneumonia（HAP） by studying the risk factors for its 30-day mortality.Methods Clinical data about 100 patients with Paeudomonas aeruginosa-induced HAP admitted to ICU in Chinese PLA General Hospital from January 2009 to October 2011 were retrospectively investigated and risk factors for their 30-day mortality were analyzed.Drug sensitivity test was performed for Paeudomonas aeruginosa isolated from the lower respiratory tract.Results High APACHEⅡscore and uncovered pathogens（P=0.01） were the risk factors for 30-day mortality of HAP patients.The resistance rate of Paeudomonas aeruginosa to ceftazidime,ciprofloxacin,cefepime and piperacillin/tazobactam was very low,accounting for 17%,19%,21% and 26%,respectively.Conclusion High APACHEⅡscore and uncovered pathogens are the risk factors for 30-day mortality of HAP patients.The anti-Paeudomonas aeruginosa activity of ceftazidime,ciprofloxacin,cefepime and piperacillin/tazobactam is rather good.