| 摘要: |
| 目的探讨替加环素耐药肺炎克雷伯杆菌医院感染老年患者的临床特点。方法对发生医院感染且分离培养到替加环素耐药肺炎克雷伯杆菌的87例患者临床资料进行分析，比较老年患者（≥60岁，45例）与非老年患者（＜60岁，42例）的性别、年龄、住院时间、科室分布、感染部位、抗生素使用情况、临床操作、合并基础疾病、临床感染指标、疾病转归等。结果两组患者性别、住院时间、替加环素耐药前各类抗生素使用率比较，差异均无统计学意义（均P＞0.05）。老年组脑科重症监护病房、肺部感染、气管插管及使用呼吸机、合并高血压及脑血管疾病者比例均明显高于非老年组（均P＜0.05）。感染期间老年组C反应蛋白及降钙素原最低值、末次测量值均明显高于非老年组（均P＜0.05）。两组患者疾病转归比较，非老年组优于老年组（P＜0.05）。结论老年替加环素耐药肺炎克雷伯杆菌感染部位主要为肺部，可能与气管插管及使用呼吸机等操作有关；应重视合并高血压或脑血管疾病的老年患者发生替加环素耐药肺炎克雷伯杆菌感染。 |
| 关键词: 老年人 替加环素 肺炎克雷伯杆菌 临床特点 |
| DOI：10.12056/j.issn.1006-2785.2018.40.18.2016-2146 |
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| Clinical features of elderly patients with nosocomial infection caused by tigecycline-resistant klebsiella pneumoniae |
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the Second Affiliated Hospital，Zhejiang University School of Medicine
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| Abstract: |
| Objective To analyze the clinical features of elderly patients with nosocomial infection caused by tigecycline-resistant klebsiella pneumonia (TRKp). Methods Eighty seven patients with TRKp infection were enrolled enrolled in the study, including 45 patients aged ≥60 years(elderly group) and 42 patients aged ＜60 years(non-elderly group). Age, length of hospital stay, departmental distribution, site of infection, use of antibiotics, clinical management, comorbidities, clinical signs of infection, disease outcome were compared between two groups. Results There were no significant differences in gender, length of hospital stay and the previous use of antibiotics between the two groups. The proportion of patients in neurosurgery intensive care unit, pulmonary infection, the tracheal intubation and mechanical ventilator, complicating hypertension and cerebrovascular disease in elderly group was significantly higher than that in the non-elderly group (P ＜0.05). The lowest and last values of C-reactive protein as well as procalcitonin in the elderly group were significantly higher than those in the non-elderly group (P＜ 0.05). The outcomes in non-elderly group were better than those in the elderly group (P＜0.05). Conclusion TRKp infection mainly occurred in lung of the elderly patients, which may be related to the use of ventilator. More attention should be paid to TRKp infection in elderly patients with coexisting hypertension or cerebrovascular disease. |
| Key words: The elderly Tigecycline Klebsiella pneumonia Clinical features |
