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洋葱伯克霍尔德菌性肺炎的诊治

Diagnosis and Treatment for Burkholderia cepacia pneumonia

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【作者】 孙忠民杨岚陈明伟陈小燕

【Author】 SUN Zhong-min,YANG Lan,CHEN Ming-wei,CHEN Xiao-yan (The First Affiliated Hospital,Medical School of Xi′an Jiaotong University,Xi′an,Shaanxi 710061,China)

【机构】 西安交通大学医学院第一附属医院呼吸内科

【摘要】 目的探讨洋葱伯克霍尔德菌(BCE)性肺炎的诊断和治疗方法。方法对医院2005年7月-2007年12月共31例住院和门诊患者进行分析。结果社区获得性肺炎11例,医院获得性肺炎20例;27例有基础疾病,其中肾移植术后19例,慢性阻塞性肺疾病4例,2型糖尿病7例,脑血管疾病3例,恶性肿瘤2例;全部病例均通过支气管镜检查,支气管肺泡灌洗,灌洗液培养出BCE而确诊;治愈24例(77.4%),自动出院2例(6.5%),死亡5例(16.1%)。结论BCE是多药耐药菌,BCE性肺炎常常表现为重症,早期临床表现无特异性,病死率较高,治疗应尽早使用以哌拉西林/他唑巴坦为主的联合抗感染治疗。

【Abstract】 OBJECTIVE To discuss the diagnosis and treatment of Burkholderia cepacia(BCE) pneumonia. METHODS The 31 cases of inpatients and outpatients in our hospital were analyzed from Jul 2005 to Dec 2007. RESULTS From them 11 cases were with community-acquired pneumonia and 20 cases with hospital-acquired pneumonia,the underlying diseases in 27 cases.Of these cases,19 cases were kidney transplant recipients,four cases with chronic obstructive pulmonary disease,seven cases with non-insulin dependent diabetes,three cases with cerebral vascular diseases,and two cases were with malignant tumors.All cases were diagnosed by bronchoscopy,bronchial lavage,and BCE positive in douche liquid.At last there were 24(77.4%) cases cured,2 cases discharged(6.5%) and 5 cases deceased(16.1%). CONCLUSIONS BCE is a multi-drug resistant bacteria.BCE pneumonia often appears severe.It appears non-specific clinical symptoms in early stage and higher mortality.It should be treated as soon as possible by using piperacillin /tazobactam-based combined anti-infection treatment.

【关键词】 洋葱伯克霍尔德菌肺炎诊断治疗
【Key words】 Burkholderia cepaciaPneumoniaDiagnosisTreatment
  • 【文献出处】 中华医院感染学杂志 ,Chinese Journal of Nosocomiology , 编辑部邮箱 ,2009年15期
  • 【分类号】R516;R563.1
  • 【被引频次】6
  • 【下载频次】212
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