Clinical Focus ›› 2022, Vol. 37 ›› Issue (4): 315-319.doi: 10.3969/j.issn.1004-583X.2022.04.005
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Zhu Ying, Shu Qianqian, Chen Fuhui()
Received:
2021-09-22
Online:
2022-04-20
Published:
2022-05-13
Contact:
Chen Fuhui
E-mail:chenfuhui2019@163.com
CLC Number:
Zhu Ying, Shu Qianqian, Chen Fuhui. Clinical characteristics and drug resistance of community-acquired Acinetobacter baumannii pneumonia[J]. Clinical Focus, 2022, 37(4): 315-319.
临床资料 | 例数[例(%)] |
---|---|
年龄 | |
<65岁 | 16(36.4) |
≥65岁 | 28(63.6) |
性别 | |
男 | 26(59.1) |
女 | 18(40.9) |
合并症 | |
心脏疾病 | 29(65.9) |
呼吸疾病 | 21(47.7) |
消化系统疾病 | 4(9.1) |
血栓 | 6(13.6) |
糖尿病 | 16(36.4) |
肿瘤 | 10(22.7) |
骨折 | 6(13.6) |
神经系统疾病 | 21(47.7) |
个人史 | |
饮酒史 | 7(15.9) |
吸烟史 | 13(29.5) |
抗生素使用史 | 19(43.2) |
重症肺炎 | |
是 | 16(36.4) |
否 | 28(63.6) |
临床资料 | 例数[例(%)] |
---|---|
年龄 | |
<65岁 | 16(36.4) |
≥65岁 | 28(63.6) |
性别 | |
男 | 26(59.1) |
女 | 18(40.9) |
合并症 | |
心脏疾病 | 29(65.9) |
呼吸疾病 | 21(47.7) |
消化系统疾病 | 4(9.1) |
血栓 | 6(13.6) |
糖尿病 | 16(36.4) |
肿瘤 | 10(22.7) |
骨折 | 6(13.6) |
神经系统疾病 | 21(47.7) |
个人史 | |
饮酒史 | 7(15.9) |
吸烟史 | 13(29.5) |
抗生素使用史 | 19(43.2) |
重症肺炎 | |
是 | 16(36.4) |
否 | 28(63.6) |
临床症状 | 总体 (n=44) | 重症肺炎组 (n=16) | 非重症肺炎组 (n=28) | χ2值 | P值 |
---|---|---|---|---|---|
发热 | 18(40.9) | 11(68.8) | 7(25.0) | 8.062 | 0.005 |
乏力 | 10(22.7) | 4(25.0) | 6(21.4) | 0.074 | 1.000 |
肌肉、关节痛 | 3(6.8) | 1(6.3) | 2(7.1) | 0.013 | 1.000 |
畏寒 | 3(6.8) | 1(6.3) | 2(7.1) | 0.013 | 1.000 |
寒战 | 6(13.6) | 4(25.0) | 2(7.1) | 2.757 | 0.169 |
咳嗽 | 36(81.8) | 8(50.0) | 28(100.0) | 17.111 | 0.000 |
咳痰 | 33(75.0) | 9(56.3) | 24(85.7) | 4.714 | 0.067 |
呼吸困难 | 34(77.3) | 11(68.8) | 23(82.1) | 1.040 | 0.456 |
胸闷 | 6(13.6) | 1(6.3) | 5(17.9) | 1.165 | 0.392 |
咯血 | 5(11.4) | 0 | 5(17.9) | 3.223 | 0.141 |
胸痛 | 6(13.6) | 2(12.5) | 4(14.3) | 0.028 | 1.000 |
心悸 | 5(11.4) | 0 | 5(17.9) | 3.223 | 0.141 |
恶心 | 1(2.3) | 0 | 1(3.6) | 0.585 | 1.000 |
腹痛 | 1(2.3) | 0 | 1(3.6) | 0.585 | 1.000 |
腹泻 | 1(2.3) | 0 | 1(3.6) | 0.585 | 1.000 |
呕吐 | 2(4.5) | 1(6.3) | 1(3.6) | 0.168 | 1.000 |
临床症状 | 总体 (n=44) | 重症肺炎组 (n=16) | 非重症肺炎组 (n=28) | χ2值 | P值 |
---|---|---|---|---|---|
发热 | 18(40.9) | 11(68.8) | 7(25.0) | 8.062 | 0.005 |
乏力 | 10(22.7) | 4(25.0) | 6(21.4) | 0.074 | 1.000 |
肌肉、关节痛 | 3(6.8) | 1(6.3) | 2(7.1) | 0.013 | 1.000 |
畏寒 | 3(6.8) | 1(6.3) | 2(7.1) | 0.013 | 1.000 |
寒战 | 6(13.6) | 4(25.0) | 2(7.1) | 2.757 | 0.169 |
咳嗽 | 36(81.8) | 8(50.0) | 28(100.0) | 17.111 | 0.000 |
咳痰 | 33(75.0) | 9(56.3) | 24(85.7) | 4.714 | 0.067 |
呼吸困难 | 34(77.3) | 11(68.8) | 23(82.1) | 1.040 | 0.456 |
胸闷 | 6(13.6) | 1(6.3) | 5(17.9) | 1.165 | 0.392 |
咯血 | 5(11.4) | 0 | 5(17.9) | 3.223 | 0.141 |
胸痛 | 6(13.6) | 2(12.5) | 4(14.3) | 0.028 | 1.000 |
心悸 | 5(11.4) | 0 | 5(17.9) | 3.223 | 0.141 |
恶心 | 1(2.3) | 0 | 1(3.6) | 0.585 | 1.000 |
腹痛 | 1(2.3) | 0 | 1(3.6) | 0.585 | 1.000 |
腹泻 | 1(2.3) | 0 | 1(3.6) | 0.585 | 1.000 |
呕吐 | 2(4.5) | 1(6.3) | 1(3.6) | 0.168 | 1.000 |
影像学 | 总体 (n=44) | 重症肺炎组 (n=16) | 非重症肺炎组 (n=28) | χ2值 | P值 |
---|---|---|---|---|---|
间质改变 | 20(45.5) | 6(37.5) | 14(50.0) | 0.642 | 0.423 |
肺结节 | 17(38.6) | 6(37.5) | 11(39.3) | 0.014 | 0.907 |
磨玻璃影 | 11(25.0) | 4(25.0) | 7(25.0) | 0.585 | 1.000 |
渗出 | 33(75.0) | 10(62.5) | 23(82.1) | 2.095 | 0.169 |
气肿 | 6(13.6) | 2(12.5) | 4(14.3) | 0.028 | 1.000 |
空洞 | 3(6.8) | 2(12.5) | 1(3.6) | 1.278 | 0.543 |
高密度影 | 6(13.6) | 3(18.8) | 3(10.7) | 0.558 | 0.652 |
实变 | 3(6.8) | 3(18.8) | 0 | 5.634 | 0.042 |
胸腔积液 | 24(54.5) | 11(68.8) | 13(46.4) | 2.046 | 0.153 |
斑索 | 15(34.1) | 5(31.3) | 10(35.7) | 0.090 | 0.764 |
纵隔淋巴结肿大 | 10(22.7) | 5(31.3) | 5(17.9) | 0.201 | 0.732 |
网格影 | 3(6.8) | 1(6.3) | 2(7.1) | 0.013 | 1.000 |
双肺受累 | 38(86.4) | 16(100.0) | 22(78.6) | 0.278 | 0.543 |
多形态表现 | 36(81.8) | 14(87.5) | 22(78.6) | 0.546 | 0.689 |
影像学 | 总体 (n=44) | 重症肺炎组 (n=16) | 非重症肺炎组 (n=28) | χ2值 | P值 |
---|---|---|---|---|---|
间质改变 | 20(45.5) | 6(37.5) | 14(50.0) | 0.642 | 0.423 |
肺结节 | 17(38.6) | 6(37.5) | 11(39.3) | 0.014 | 0.907 |
磨玻璃影 | 11(25.0) | 4(25.0) | 7(25.0) | 0.585 | 1.000 |
渗出 | 33(75.0) | 10(62.5) | 23(82.1) | 2.095 | 0.169 |
气肿 | 6(13.6) | 2(12.5) | 4(14.3) | 0.028 | 1.000 |
空洞 | 3(6.8) | 2(12.5) | 1(3.6) | 1.278 | 0.543 |
高密度影 | 6(13.6) | 3(18.8) | 3(10.7) | 0.558 | 0.652 |
实变 | 3(6.8) | 3(18.8) | 0 | 5.634 | 0.042 |
胸腔积液 | 24(54.5) | 11(68.8) | 13(46.4) | 2.046 | 0.153 |
斑索 | 15(34.1) | 5(31.3) | 10(35.7) | 0.090 | 0.764 |
纵隔淋巴结肿大 | 10(22.7) | 5(31.3) | 5(17.9) | 0.201 | 0.732 |
网格影 | 3(6.8) | 1(6.3) | 2(7.1) | 0.013 | 1.000 |
双肺受累 | 38(86.4) | 16(100.0) | 22(78.6) | 0.278 | 0.543 |
多形态表现 | 36(81.8) | 14(87.5) | 22(78.6) | 0.546 | 0.689 |
总体 (n=44) | 重症肺炎组 (n=16) | 非重症肺炎组 (n=28) | χ2值 | P值 | |
---|---|---|---|---|---|
PSI评分 | |||||
1分 | 1(2.3) | 1(6.3) | 0 | ||
2分 | 8(18.2) | 2(12.5) | 6(21.4) | ||
3分 | 6(13.6) | 0 | 6(21.4) | 7.311 | 0.095 |
4分 | 25(56.8) | 12(75.0) | 13(46.4) | ||
5分 | 4(9.1) | 1(6.3) | 3(10.7) | ||
转归 | |||||
好转 | 41(93.2) | 14(87.5) | 27(96.4)* | ||
未愈 | 2(4.5) | 2(12.5) | 0 | 3.569 | 0.127 |
死亡 | 1(2.3) | 0 | 1(3.6) |
总体 (n=44) | 重症肺炎组 (n=16) | 非重症肺炎组 (n=28) | χ2值 | P值 | |
---|---|---|---|---|---|
PSI评分 | |||||
1分 | 1(2.3) | 1(6.3) | 0 | ||
2分 | 8(18.2) | 2(12.5) | 6(21.4) | ||
3分 | 6(13.6) | 0 | 6(21.4) | 7.311 | 0.095 |
4分 | 25(56.8) | 12(75.0) | 13(46.4) | ||
5分 | 4(9.1) | 1(6.3) | 3(10.7) | ||
转归 | |||||
好转 | 41(93.2) | 14(87.5) | 27(96.4)* | ||
未愈 | 2(4.5) | 2(12.5) | 0 | 3.569 | 0.127 |
死亡 | 1(2.3) | 0 | 1(3.6) |
耐药类型 | 株数 | 占比(%) |
---|---|---|
多重耐药 | 14 | 31.8 |
泛耐药 | 7 | 15.9 |
全耐药 | 1 | 2.3 |
耐碳青霉烯类 | 24 | 54.5 |
耐药类型 | 株数 | 占比(%) |
---|---|---|
多重耐药 | 14 | 31.8 |
泛耐药 | 7 | 15.9 |
全耐药 | 1 | 2.3 |
耐碳青霉烯类 | 24 | 54.5 |
药物 | 耐药 | 敏感 | 中介 | |||||
---|---|---|---|---|---|---|---|---|
株数 | 耐药率(%) | 株数 | 敏感率(%) | 株数 | 中介率(%) | |||
头孢吡肟 | 18 | 40.9 | 20 | 45.5 | 6 | 13.6 | ||
头孢他啶 | 20 | 45.5 | 24 | 54.5 | 0 | 0 | ||
哌拉西林/他唑巴坦 | 24 | 54.5 | 19 | 43.2 | 1 | 2.3 | ||
氨苄西林/舒巴坦 | 19 | 43.2 | 24 | 54.5 | 1 | 2.3 | ||
头孢哌酮/舒巴坦 | 15 | 34.1 | 25 | 56.8 | 4 | 9.1 | ||
阿米卡星 | 15 | 34.1 | 29 | 65.9 | 0 | 0 | ||
庆大霉素 | 21 | 47.7 | 23 | 52.3 | 0 | 0 | ||
妥布霉素 | 15 | 34.1 | 27 | 61.4 | 2 | 4.5 | ||
环丙沙星 | 23 | 52.3 | 21 | 47.7 | 0 | 0 | ||
左氧氟沙星 | 16 | 36.4 | 21 | 47.7 | 7 | 15.9 | ||
亚胺培南 | 23 | 52.3 | 20 | 45.5 | 1 | 2.3 | ||
美罗培南 | 23 | 52.3 | 20 | 45.5 | 1 | 2.3 | ||
多西环素 | 19 | 43.2 | 25 | 56.8 | 0 | 0 | ||
米诺环素 | 4 | 9.1 | 26 | 59.1 | 14 | 31.8 | ||
复方新诺明 | 12 | 27.3 | 32 | 72.7 | 0 | 0 | ||
替加环素 | 0 | 0 | 39 | 88.6 | 5 | 11.4 | ||
多黏菌素 | 5 | 11.4 | 39 | 88.6 | 0 | 0 |
药物 | 耐药 | 敏感 | 中介 | |||||
---|---|---|---|---|---|---|---|---|
株数 | 耐药率(%) | 株数 | 敏感率(%) | 株数 | 中介率(%) | |||
头孢吡肟 | 18 | 40.9 | 20 | 45.5 | 6 | 13.6 | ||
头孢他啶 | 20 | 45.5 | 24 | 54.5 | 0 | 0 | ||
哌拉西林/他唑巴坦 | 24 | 54.5 | 19 | 43.2 | 1 | 2.3 | ||
氨苄西林/舒巴坦 | 19 | 43.2 | 24 | 54.5 | 1 | 2.3 | ||
头孢哌酮/舒巴坦 | 15 | 34.1 | 25 | 56.8 | 4 | 9.1 | ||
阿米卡星 | 15 | 34.1 | 29 | 65.9 | 0 | 0 | ||
庆大霉素 | 21 | 47.7 | 23 | 52.3 | 0 | 0 | ||
妥布霉素 | 15 | 34.1 | 27 | 61.4 | 2 | 4.5 | ||
环丙沙星 | 23 | 52.3 | 21 | 47.7 | 0 | 0 | ||
左氧氟沙星 | 16 | 36.4 | 21 | 47.7 | 7 | 15.9 | ||
亚胺培南 | 23 | 52.3 | 20 | 45.5 | 1 | 2.3 | ||
美罗培南 | 23 | 52.3 | 20 | 45.5 | 1 | 2.3 | ||
多西环素 | 19 | 43.2 | 25 | 56.8 | 0 | 0 | ||
米诺环素 | 4 | 9.1 | 26 | 59.1 | 14 | 31.8 | ||
复方新诺明 | 12 | 27.3 | 32 | 72.7 | 0 | 0 | ||
替加环素 | 0 | 0 | 39 | 88.6 | 5 | 11.4 | ||
多黏菌素 | 5 | 11.4 | 39 | 88.6 | 0 | 0 |
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