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目的加强对气单胞菌败血症的认识,分析90例慢性肝病患者气单胞菌败血症的临床及病原学特点、耐药性及治疗转归。方法查阅2001—2015年住院的肝病患者气单胞菌败血症病例,回顾性分析其临床特征、病原药物敏感性及转归。结果90例气单胞菌败血症中57.78%为院内感染,94.44%患者的基础疾病为肝硬化。临床表现均有发热,50(55.56%)例伴有寒战,高度乏力37(41.11%)例,黄疸加重30(33.33%)例,14(15.56%)例同时存在腹痛及腹泻,13(14.44%)例发生感染性休克。感染菌种以嗜水气单胞菌(47.78%)占优势,16.67%的患者有广谱抗生素应用史,26.67%的患者有抑酸药物应用史。气单胞菌对氨苄西林(96.50%)、头孢唑林(95.60%)、亚胺培南(69.40%)、替卡西林(42.10%)、哌拉西林(34.90%)、复方磺胺甲噁唑(32.70%)和美罗培南(30.60%)的不敏感率较高。按药敏及时抗感染治疗,治愈率和好转率分别为66.67%和21.11%。结论气单胞菌败血症易发生于肝硬化患者,以嗜水气单胞菌为主,有其临床特征及病原学特点,应高度重视,及时针对性抗菌药物治疗。
OBJECTIVE: To enhance the understanding of Aeromonas coli sepsis and analyze the clinical and etiological characteristics, drug resistance and treatment of Aeromonas sepsis in 90 patients with chronic liver disease. Methods A retrospective analysis was made on the clinical characteristics, pathogenic drug sensitivity and outcome of hospitalized patients with cirrhosis of Aeromonas from 2001 to 2015. Results 57.78% of 90 cases of Aeromonas sepsis was nosocomial infection, and 94.44% of patients had cirrhosis. Clinical manifestations were fever, 50 (55.56%) cases associated with chills, high fatigue 37 (41.11%) cases, jaundice increased 30 (33.33%) cases, 14 (15.56%) cases of abdominal pain and diarrhea, 13 (14.44% ) Cases of septic shock. Infected strains of Aeromonas hydrophila (47.78%) predominance, 16.67% of patients with broad-spectrum antibiotic application history, 26.67% of patients with acid-suppressing drug application history. Aeromonas aeruginosa was resistant to ampicillin (96.50%), cefazolin (95.60%), imipenem (69.40%), ticarcillin (42.10%), piperacillin (34.90% (32.70%) and meropenem (30.60%) insensitive rate is higher. According to drug sensitivity and timely anti-infection treatment, the cure rate and improvement rate were 66.67% and 21.11% respectively. Conclusion Aeromonas bacterial septicemia is easy to occur in patients with cirrhosis, mainly Aeromonas hydrophila, with its clinical features and etiological characteristics, should attach great importance to timely and targeted antibiotic treatment.