摘要
目的调查分析非发酵菌败血症的临床特点,耐药情况,危险因素及流行情况,指导临床诊断和合理使用抗菌药。方法回顾性分析四川省人民医院2002-10/2010-10血培养为非发酵菌的败血症52例,收集分析相关的病史资料及实验室数据。结果 52例非发酵菌败血症主要分布于ICU(18例)、血液科(13例)及呼吸科(5例),均为院内感染。主要感染病菌为铜绿假单胞菌(28株)、鲍曼不动杆菌(20株)。其中ICU以鲍曼不动杆菌为主,血液科以铜绿假单胞菌为主,且表现为多重耐药性。52例患者均有严重基础疾病,血液病14例,胰腺炎12例,其他恶性肿瘤6例,慢性肾功能衰竭8例,糖尿病7例。14例因感染死亡。结论 52例院内获得非发酵菌败血症主要分布发生于ICU、血液科、呼吸科,以铜绿假单胞菌、鲍曼不动杆菌为主要致病菌,耐药率高,其发生与患者基础疾病和激素的使用、免疫抑制状态及静脉置管、住院时间长等危险因素有关,抗感染治疗难度大,治疗费用高,死亡率高,应引起临床的高度关注。
Objective To analyze clinical and laboratory data of patients with hospital acquired non-fermenting bacterial septicemia and provide evidences for clinical diagnosis and chemotherapy.Methods The clinical and microbiological features,antimicrobial resistance patterns,risk factors were assayed retrospectively based on 52 cases from October 2002 to October 2010.Results Most patients were distributed in ICU,hematology department（18 cases）,department of hematology（13 cases） and respiratory（5 cases）.The main bacteria were Pseudomonas aeruginosa（28 plants） and Acinetobacter baummannii（20 plants）.The most strains of Acinetobacter baummannii were isolated from ICU,and Pseudomonas aeruginosa from hematology department,which were mostly multi-drug resistant or pan-drug resistant.All the 52 patients had severe underlying diseases： 14cases of blood diseases,12 cases of pancreatitis,6 cases of other malignancies,8 cases of chronic renal failure and 7 cases of diabetes.Fourteen cases died of non-fermenting bacterial septicemia.Conclusion The hospital-acquired non-fermentative bacteria sepsis patients are mainly distributed in ICUs and departments of hematology,respiratory.Pseudomonas aeruginosa and Acinetobacter baumannii are the major pathogens,with a high resistance rate;and risk factors are underlying diseases,hormone usage,venous catheters,immunosuppressive status and long term hospital dwelling.The great difficulty of anti-infective treatment,high cost of treatment and high mortality rate should all be paid great clinical attention to.
出处
《预防医学情报杂志》
CAS
2013年第3期248-250,共3页
Journal of Preventive Medicine Information
关键词
非发酵菌
医院感染
败血症
耐药性
non-fermenting bacteria
hospital acquired infection
septicemia
drug resistance
