摘要
目的分析ICU患者鲍曼不动杆菌感染的临床特点,为患者感染的防治提供建议。方法回顾性分析我院2010年3月至2014年3月ICU病房收治的1337例患者,分析其鲍曼不动杆菌感染情况及临床特点。结果共检出鲍曼不动杆菌感染患者142例,感染率10.6%;其中外科术后患者、呼吸系统病变患者感染率最高,分别为52.9%及19.2%;感染患者主要集中于>60岁、行气管插管、行气管切开、应用抗菌药物、合并症≥2种及住院时间≥10 d,其感染率分别为13.4%、9.0%、11.8%、11.5%、13.4%及13.7%;我院ICU鲍曼不动杆菌对妥布霉素、庆大霉素及诺氟沙星耐药率较高,分别为78.9%、76.8%及73.2%,对亚胺培南耐药率较低,为5.6%;142例感染患者共死亡26例,死亡率18.3%,其中碳青霉烯治疗方案ICU转出率最高,达91.4%。结论 ICU患者鲍曼不动杆菌感染率较高,因感染导致的死亡率亦较高,而鲍曼不动杆菌具有广泛耐药,在今后的治疗中,应根据其耐药规律,选择合适的抗菌药物,并严格落实无菌规定,以降低感染率,改善患者预后。
Objective To analyze the clinical characteristics oflCU patients with A cinetobacter Baumanii, and to provide suggestions for the prevention of infection. Methods A retrospective analysis of 1 337 ICU patients of our hospital from March 2010 to March 2014 was carried out in order to analyse the infection ofAcinetobacter Baumanii and its clinical characteristics. Results A total of 142 patients were infected with A cine rob acte r Baumanii, with a infection rate of 10.6%. The prevalence of infection among the patients with surgical operation or respiratory system diseases was highest, respectively 52.9% and 19.2%. The infected patients were mainly over 60 years old, received endotracheal intubation or tracheotomy, had administration of antibacterial drugs, had more than 2 complications, and were hospitalized more than 10 days; the respective infection rate was 13.4%, 9%, 11.8%, 11.5%, 13.4% and 13.7%. The patients infected with Acinetobacter Baumanii in our hospital had higher drug resistance for Tobramycin, Gentamicin and Norfloxacin, respectively 78.9%, 76.8% and 73.2%, and had lower drug resistance for Imipenem, only 5.6%. A total of 26 patients died among the 142 infected patients, with a mortality of 18.3%. The ICU-departed rate of the patients who received the carbapenem therapy was highest, up to 91.4%. Conclusions The prevalence ofAcinetobacter Baumanii infenction is higher among the ICU patients. Because the mortality is high and it is extensively drug-resisted, appropriate antimicrobial agents and strict implementation of aseptic requirements should be implemented in future treatments, in order to reduce infection rates and improve the prognosis of the patients.
出处
《临床医学工程》
2014年第7期855-856,859,共3页
Clinical Medicine & Engineering
关键词
重症监护室
鲍曼不动杆菌
感染
临床特点
ICU
A cinetobazter Baumanii
Infection
Clinical characteristics
