呼吸重症监护病房铜绿假单胞菌肺部感染对治疗及-第三军医大学学报.DOCVIP

呼吸重症监护病房铜绿假单胞菌肺部感染临床分析目的方法的结果结论A clinical analysis of pseudomonas aeruginosa pulmonary infection in respiratory intensive care unit Luo Li，Zhang Mingzhou，Liu Shuanglin，Yang Li，Li Qi，Wang Changzheng ( Institute of Respiratory Diseases，Xinqiao Hospital，the Third Military Medical University，Chongqing 400037，China) [Abstract] Objective To investigate the effect of pseudomonas aeruginosa (PA) pulmonary infection on the treatment and prognosis of patients in respiratory intensive care unit (RICU). Methods A retrospective case-control study was conducted on 21 patients with PA infections (PA infection group) and 42 patients with non-PA infection (control group). The patients’ clinical indices including sex, age, smoking history, underlying disease, pathogenic bacteria distribution, drug sensitive test result, hospitalization time, hospitalization expense, invasive operation and progenesis were analyzed respectively. Results The resistance rate of PA to Imipenem accounted for 71.4% in PA infection group. The incidences of endotracheal intubation, tracheostomy and invasive mechanical ventilation of the PA infection group were higher than those of the control group (P0.01). As compared with the control group, patients of the PA infection group had longer hospitalization time, higher hospitalization expenses and a lower improvement rate (P0.01). Conclusions Invasive mechanical ventilation is a risk factor for patients complicated with PA pulmonary infection in RICU. [Key words] respiratory intensive care unit; pseudomonas aeruginosa; mechanical ventilation; prognosis Corresponding author: Wang Changzheng, E-mail: czwang@铜绿假单胞菌(pseudomonas aeruginosa，PA)是一种临床上最常见的引起严重院内获得性感染的条件致病菌。我国全国性革兰阴性菌耐药监测(NPRS)数据显示：1994~2001 年，PA在所有院内感染革兰阴性菌中居第 1 位[1]，尤其成为重症监护病房(intensive care unit，ICU)发生医院感染的重要致病菌[2]。因其感染宿主多为免疫功能低下和接受侵袭性操作者，且该菌具有易定植、变异、天然耐药和耐药机制的复杂性等特征，可能造成医院感染的流行甚至暴发流行，使其成为临床治疗中亟待解决的难题。过去对院内PA感染的耐药情况报道较多，但关于PA肺部感染对治疗及预后影响的研究并不多。因此，本文旨在探讨RICU患者PA肺部感染的诊疗及预后情况，对减少PA感染的发生，改善患者预后有重要意义。 1