不动杆菌致下呼吸道感染70例临床特点及其药敏分析

目的：分析不动杆菌下呼吸道感染的临床特点和监测不动杆菌对常用抗生素的药物敏感性。方法：回顾性分析广州市第一人民医院2002年1月-2003年12月不动杆菌致下呼吸道感染70例的临床资料，从痰标本中分离所得70株不动杆菌，并采用K—B法进行药敏监测。结果：所有病人均患有较严重的基础疾病，曾反复使用一种或多种抗生素，48．6％有混合感染。药敏监测结果表明，不动杆菌对泰能最为敏感，达98．5％，对替卡西林 克拉维酸、头孢哌酮 舒巴坦及喹诺酮类抗生素环丙沙星亦有较好的抗菌活性，对β-内酰胺酶类抗生素头孢噻肟、哌拉西林及单环类如氨曲南有较高的耐药性。结论：不动杆菌致下呼吸道感染多有较严重的基础疾病，病情复杂，应及时选择敏感的抗生素治疗如加β-内酰胺酶抑制剂的半合成青霉素类治疗，必要时可改亚胺培南治疗。

Analysis on Drug Susceptibility and Clinical Features of 70 Cases of Lower Respiratory Infection Caused by Acinetobacter

Objective: To find the clinical features and the sensitivity to commonly used antibiotic of lower respiratory infection caused by acinetobacter. Methods: We analyzed retrospectively the data of the clinical manifestations of the 70 cases of lower respiratory infection caused by acinetobacter in the Guangzhou First Municipal Hospital during the years 2002-2003. To detect the drug susceptibility to acinetobacter, 70 strains acinetobacter were isolated from sputum of 70 patients with lower respiratory infection. Bacterial susceptibility testing was carried out by Kirby-Baucer disk diffusion method. Result: All of the patients who suffered low respiratory infection caused by acinetobacter severely suffered other diseases. At least one kind of antibiotic was used in all cases. 48.6% of the patients had mixed infection. The result of bacterial susceptibility testing showed tienam had the most effective antimicrobial activity among the frequently used antibiotics. The susceptibility rate was 98.5%. Ticarcillin/clavulanic acid, Cefoperazone/Sulbactam and Quinolones such as eiprofloxacin had a very good antibacterial activity against acinetobacter. Beta-lactams such as cefotaxime, Piperacillin and Azthreonam showed a quite low activity. Conclusion: Lower respiratory infection caused by acinetobacter is very complicated. It is important to use sensitive antibiotic such as Semi-synthesis penicillin plus beta lactamase inhibitor combining Quinolones at times. Imipenem is a good choice as needed.