呼吸重症老年患者多重耐药鲍曼不动杆菌感染特征分析

Analysis of the characteristics of multi-drug resistant acinetobacter baumannii infection in elderly patients with severe respiratory

目的探讨呼吸重症老年多重耐药鲍曼不动杆菌感染患者的临床特点。方法选取2014年1月至2015年12月在我院呼吸重症病房住院时感染多重耐药鲍曼不动杆菌的102例老年患者作为研究组，同时选取未出现多重耐药鲍曼不动杆菌感染的老年患者作为对照组，比较两组患者性别、年龄、抗菌药物使用情况、白细胞计数、机械通气时间等指标之间的差异。结果两组患者住院天数[（18．7±7．5）d比（10．0±2．7）d]、有创呼吸机应用时间[（24．6±10．3）d比（11．6±6．9）d3、抗菌药物应用时间[（26．2±13．1）d比（8．0±2．6）d3比较差异有统计学意义（t=19．463、15．436、26．905，均P〈0．05）；而免疫抑制剂使用时间、白细胞计数、血清蛋白水平以及APACHEⅡ评分比较差异无统计学意义（均P〉0．05）。结论合理科学地应用抗菌药物、减少有创机械通气时间以及提高患者免疫力有助于降低呼吸重症老年患者感染多重耐药鲍曼不动杆菌的概率。

Objective To investigate the clinical characteristics of multiple drug resistant Acinetobacter baumannii infection in respiratory elderly patients. Methods A total of 102 elderly patients infected with muiltidrug-resistant Acinetobacter baumannii were enrolled in our hospital from January 2014 to December 2015. At the same time,no multiple drug-resistant Acinetobacter baumannii infection elderly patients was selected as a control group. The gender, age, antimicrobial use, white blood cell count, mechanical ventilation time and other differences between the two groups of elderly patients were compared. Results There were significant differences in the days of hospitalization [（18.7±7.5） d vs. （10.0±2.7）d],the time of application of invasive ventilator（（24.6±10.3） d vs. （11.6±6.9）d] and the time of application of antimicrobial agents[（26.2±13.1） d vs. （8.0±2.6）d] （t= 19. 463,15. 436,26. 905, all P〈0.05）. There was no significant difference in immunosuppressant use,white blood cell count,serum protein level and APACHEH score （all P〉0.05）. Conclusions Reasonable scientific application of antimicrobial agents, reducing invasive mechanical ventilation time and improving patient immunity can help to reduce the risk of respiratory infection in elderly patients with multiple drug resistance to Acinetobacter baumannii.