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-  2017 

泛耐药鲍曼不动杆菌菌血症的临床特点及预后

DOI: doi:10.7507/1671-6205.201612055

Keywords: 泛耐药鲍曼不动杆菌, 菌血症, 预后

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Abstract:

目的 对重症监护病房泛耐药鲍曼不动杆菌菌血症的临床特点及预后进行总结。 方法 回顾性研究 2012 年 1 月至2015 年 12 月 31 日北京大学第一院呼吸监护室的鲍曼不动杆菌菌血症患者,收集患者人口学特点、临床资料、3 d 及 14 d 的预后。 结果 纳入 8 例患者,平均年龄(62.4±18.0)岁,男 3 例,女 5 例。所有患者均患有基础疾病,6 例为免疫抑制患者,7 例患者发病前 2 周内接受含有 β 内酰胺酶抑制剂的复合制剂或碳青霉烯类抗菌药物,6 例接受机械通气,肺脏是主要病源。菌种鉴定均为泛耐药鲍曼不动杆菌。患病 48 h 内平均急性生理与慢性健康状况Ⅱ(APACHEⅡ)评分为(28.3±7.5)分,C 反应蛋白(18.2~231.0 mg/L)和降钙素原(0.1~25.0 ng/ml)个体差异较大。3 d 死亡率为 4/8,均为 APACHEⅡ>25 分的患者;14 d 死亡率为 6/8,PCT>0.5 ng/ml 的患者均死亡。 结论 泛耐药鲍曼不动杆菌菌血症患者 14 d 的预后和疾病严重程度及降钙素原升高有关。对于 APACHE Ⅱ>25 分、降钙素原升高、之前接受机械通气的高度可疑患者应考虑在血培养结果回报前抢先治疗

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