重视下呼吸道慢性铜绿假单胞菌感染的防治

Improving the management of chronic Pseudomonas aeruginosa infection in lower respiratory tract

铜绿假单胞菌是导致结构性肺疾病患者发生慢性下呼吸道感染的最重要的病原微生物之一,在此类疾病进展恶化的机制中,慢性铜绿假单胞菌感染可能既是结果又是原因,扮演着非常重要的角色,与不良预后有密切关系。加强下呼吸道慢性铜绿假单胞菌感染的防治对于提高支气管扩张、慢性阻塞性肺疾病等常见慢性呼吸道疾病的诊疗水平具有重要意义。在临床工作中要注意下呼吸道慢性铜绿假单胞菌感染的管理策略与急性感染治疗思路的区别,在积极控制感染的同时,还要重视其他综合防治措施,以减少急性加重的次数,改善患者的肺功能和生活质量。

Pseudomonas aeruginosa is one of the most important pathogens causing chronic lower respiratory tract infections in patients with chronic lung diseases such as cystic fibrosis,bronchiectasis and chronic obstructive pulmonary disease.The poor prognosis of these diseases has been found to be associated with chronic Pseudomonas aeruginosa infection in lower respiratory tract,which can be a consequence or a cause of the disease progression depending on different circumstances.Optimizing the management of chronic Pseudomonas aeruginosa infection is of great significance to improve the prognosis of these chronic lung diseases.Unlike the therapy of acute pneumonia due to Pseudomonas aeruginosa,the goals of the management for chronic Pseudomonas aeruginosa infection are not only to control infection,but also to reduce symptoms,prevent exacerbations,stop the disease progression and improve the quality of life.In addition to systemic anti-pseudomonas therapy during exacerbations,long-term multiple measures including anti-inflammatory therapy,immunomodulatory therapy,airway clearance techniques,mucoactive therapy,etc.should also be given to the patients with chronic lower respiratory tract infection due to Pseudomonas aeruginosa.