耐碳青霉烯乙酸钙-鲍蔓不动杆菌肺炎的临床分析

目的探讨与重症监护病房(ICU)患者耐碳青霉烯乙酸钙_鲍蔓不动杆菌(CRA.b)肺炎相关的临床相关因素,为临床预防CRA.b的感染提供依据。方法前瞻性分析本院ICU收治的78例乙酸钙_鲍蔓不动杆菌肺炎患者的临床资料,分析耐碳青霉烯乙酸钙_鲍蔓不动杆菌危险因素。结果通过CRA.b阳性患者和对碳青霉烯敏感的乙酸钙_鲍蔓不动杆菌(CSA.b)患者危险因素的比较,发现CRA.b阳性患者细菌均为多重耐药株,仅对头孢哌酮/舒巴坦耐药率相对较低,为16.2%,敏感率为41.0%。CRA.b阳性患者多频繁或超长使用碳青霉烯类抗生素,住院环境中有CRA.b。结论本院碳青霉烯类耐药鲍曼不动杆菌流行主要为医院感染所致,且多重耐药。因此,合理使用碳青霉烯类抗生素,严格控制感染尤为重要。

Clinical analysis on carbapenem-resistant acinetobacter baumannii pneumonia

Objective To investigate clinical related factors for the development of clinical pneumonia due to carbapenem-resistant acinetobacter baumannii (CRA.b), and to provide evidence for clinical prevention of CRA.b infection. Methods A prospective clinical study involing 78 patients with acinetobacter baumannii pneumonia was carried out. Results Risk factors were compared between the CRA.b infected or colonized patients and the carbapenem-susceptible acinetobacter baumannii (CSA.b) infected or colonized patients. The resistance rates to cefoperazone/sulbactam was 16.2%, while the susceptibility rates to it was 41.0%. A higher proportion of CRA.b infected or colonized patients had received frequently or over period of treatment therapy with carbapenems, had been admitted into a ward with a high density of CRA.b. The implementation of the multi component infection control measures resulted in a sharp reduction in the incidence rate of new acinetobacter baumannii infection or colonization. Conclusion The prevalence of carbapenem-resistant acinetobacter baumannii in our hospital was due to nosocomial infection. The prevalent strains were multiresistant. Rational using of carbapenem and strict compliance with basic infection control measures both important in reducing carbapenem-resistant acinetobacter baumannii pneumonia.