肺部感染铜绿假单胞菌的临床特点

Clinical Characteristics of Pulmonary Infection with Pseudomonas Aeruginosa

目的:分析肺部感染铜绿假单胞菌的临床特点。方法:对我院呼吸科2012年1月-2013年12月住院患者的痰标本中分离出的铜绿假单胞菌的病例资料进行回顾性分析。结果:检出铜绿假单胞菌85株;患者的平均年龄为(59.93±12.46)岁;平均住院天数为(13.32±6.66)天;慢性基础性肺疾病、广谱抗生素的应用、机体免疫力低下可增加该菌的感染率;发热率为43.53%,表现为低热和中等度热;发热患者与体温正常的患者相比,白细胞计数差异具有统计学意义(x2=7.6656,P=0.0056<0.05),中性粒细胞百分比差异具有统计学意义(x2=3.9027,P=0.0482<0.05)。发热患者的WBC平均为(12.53±6.16)×109/L,G%平均为为(78.85±9.10)%;敏感率>65%的抗生素有哌拉西林/他唑巴坦钠、头孢他啶、头孢哌酮/舒巴坦钠、头孢吡肟、亚胺培南、环丙沙星、左氧佛沙星,其均可作为肺部感染铜绿假单胞菌的经验性治疗药物;有无按药敏调整药物及疾病的预后,差异无统计学意义,应继续增加样本量。结论:肺部感染铜绿假单胞菌的患者临床特点变化多样。治疗时应重视感染该菌的危险因素,根据药敏结果用药。

Objective： To analysis the clinical characteristics of pulmonary infection with pseudomonas aeruginosa. Methods：The cases data of pseudomonas aeruginosa isolated from the sputum specimens in the hospitalized patients in our respiratory department from January 2012 to December 2013 were retrospectively analyzed. Results： 85 strains pseudomonas aeruginosa was checked out. The average age of the patients was（59.93±12.46）; the average hospitalization days for（13.32±6.66） days. Chronic underlying pulmonary diseases, the application of broad-spectrum antibiotics, low immunity, bacteria can increase the infection rate. Heating rate was 43.53%,characterized by low thermal and moderate degree of heat. Compared with patients with normal body temperature, white blood cell count in patients with fever had statistically significance（x2= 7.6656, P=0.00560.05）, and the difference of neutrophil percentage differences was statistically significant（x2=3.9027,P=0.04820.05）. The number of WBC in patients with fever was averaged（12.53 ±6.16）×109 /L, and G% was averaged（78.85 ±9.10）%.The antibiotics that the sensitive rate was above 65% included Piperacillin/tazobactam,Ceftaidime, Sulbactam/Cefopeerazone, Cefepime, Imipenem, Ciprofloxacin, Levofloxacin. Whether drugs adjusted according to drug susceptibility and prognosis of the disease, there was no statistically significant difference. Conclusion： The clinical characteristics in patients with lung infection of pseudomonas aeruginosa are diverse, so it should pay more attention to the risk factors of the bacteria and take the drugs according to the results of drug sensitivity.