Acinetobacter pneumonia

Introduction to Acinetobacter pneumonia Acinetobacter (acinetobacter) is an opportunistic pathogen that can cause inflammation in the lungs. It often occurs in patients with long-term hospitalization or decreased body resistance. The disease is severe. The bacteria are resistant to many commonly used antibiotics, and treatment is difficult. The mortality rate is high. basic knowledge Sickness ratio: 60% Susceptible people: no specific people Mode of infection: non-infectious Complications: meningitis

Acinetobacter pneumonia

Causes:

Acinetobacter is widely distributed in water, soil, human skin, oral mucosa, respiratory tract and genitourinary tract, especially in hospital environments. Hand contact between medical staff and patients is likely to be an important route of transmission, Acinetobacter respiratory tract. The infection is exogenous and can be endogenous. It is currently believed that the main respiratory tract infections are caused by artificial conduits of the respiratory tract, nebulizer masks, humidification bottles, and ventilator tubes.

Pathogenesis:

Acinetobacter is a gram-negative cocci or Brevibacterium that does not ferment sugar. It was attributed to a genus Acinetobacter in 1954. Acinetobacter is a conditional pathogen. Most infected people are hospitalized or physically resistant. Significantly reduced power such as malignant tumors received chemotherapy, radiotherapy, glucocorticoid therapy, the elderly and infants, bacteria in the alveoli, bronchioles invasive invasion caused by lower respiratory tract mucosa and alveolar congestion, swelling, inflammatory exudation, white blood cells Infiltration and accumulation, suppurative necrosis forms cavities and fibrosis.

Acinetobacter pneumonia prevention

The outbreak of Acinetobacter is mainly in the hospital. The main preventive measures are:

1. Actively treat the primary disease, eliminate the predisposing factors of Acinetobacter infection as soon as possible, and stop the hormone in time. For patients who use the immune system for injury, such as radiotherapy and chemotherapy, patients should actively support and strengthen nutrition, and the blood is obvious. Patients who are declining should pay more attention. For patients with chronic lung disease, nutrition should also be strengthened during hospitalization to enhance their resistance.

2. Limit the abuse and long-term application of antibiotics, especially the application of broad-spectrum antibiotics that have obvious effects on normal flora and easily cause dysbacteriosis, so as to avoid opportunistic pathogens such as Acinetobacter infection and resistant strains. In the general infection, unless the bacterial culture and drug susceptibility results are clearly indicated, tobramycin, cefuroxime, metronidazole and other antibiotics that do not interfere significantly with the normal flora should be used.

3. ICU, RICU ward should strictly disinfect various respiratory treatment devices, especially tracheal intubation and casing, suction tube, nebulizer inhaler, ventilator tube, so as to avoid bringing Acinetobacter directly into the respiratory tract to cause infection, medical care Personnel must be thoroughly hand sanitized before touching the patient.

4. Respiratory ward, infants and wards should pay attention to the disinfection of air. When cleaning the bed, do not raise dust as much as possible. Bed sheets and bedding should be replaced in time. In particular, supplies with secretions should be cleaned, disinfected and replaced in time.

5. Strictly administer the hygiene of the medical staff and even the staff. Every time the patient touches, the patient should wash his hands and then disinfect with disinfectant such as chlorhexidine or benzalkonium bromide.

6. Relics for patients with Acinetobacter infection or original infection should be thoroughly cleaned and disinfected. In particular, the tracheal cannula and other respiratory tubes used by patients should be carefully washed away, and may be disinfected with high pressure steam when possible.

Acinetobacter pneumonia complications Complications meningitis

May be complicated by meningitis and systemic infections.

Acinetobacter pneumonia symptoms Common symptoms Acoustic pleural effusion wheezing lung infection high fever empyema cold war pus diarrhea septicemia

1. Symptoms of sudden onset, chills, high fever, body temperature can be as high as 40 ° C, irregular heat type, severe cough, phlegm sticky, yellow pus, a lot of sticky purulent can be seen in the formation of abscess in the lungs, hundreds of milliliters per day, a small number of patients Sputum with blood, breathing difficulties, gastrointestinal symptoms are common nausea, fear of food, vomiting, diarrhea, the disease can be multiple infections, up to urinary tract infections, urinary pain, urgency and other symptoms.

2. Signs of secondary Acinetobacter pulmonary infection, multiple original underlying diseases or respiratory infections, slow onset, still not improved under antibiotic treatment, clinical infections aggravated, clinically easy to neglect, signs: systemic failure Obvious, cyanosis, shortness of breath, chronic lung abscess or bronchiectasis, infection may have clubbing, anemia face, chest physical examination: reduced breath sounds (affected side) and wet voice, wheezing sound (two lungs more common ), when there is empyema, it shows pleural fluid, and those with sepsis can have splenomegaly.

3. Pathogen examination Acinetobacter was detected in sputum culture.

Examination of Acinetobacter pneumonia

The white blood cell classification count increased, generally between (10 ~ 20) × 109 / L, neutrophils 80% ~ 90%, sometimes liver function abnormalities, Acinetobacter was detected in sputum culture.

X-ray chest radiographs in the lungs of the lower part of the patch, a small number of shadows, flaky dense shadow seen in the translucent area, multiple, pleural effusion see X-ray signs of pleural effusion.

Diagnosis and identification of Acinetobacter pneumonia

Diagnostic criteria

It mainly relies on bacterial culture, but care should be taken to determine Acinetobacter, and the following conditions must be met:

1 have signs and symptoms of respiratory infections;

2 Aeruginosa growth is carried out in two consecutive sputum cultures;

3 Acinetobacter is pure culture or dominant bacteria.

Acinetobacter infection should be suspected in the following clinical situations:

1 Inpatients (ICU) with reduced body resistance, patients in intensive care units, infections or double infections in patients with artificial airways and ventilators;

2 clinical manifestations appear to be Gram-negative bacterial infections, but when ampicillin and cephalosporin antibiotics are not effective;

3 long-term use of a variety of antibiotics respiratory infections can not be controlled, suspicious patients should repeatedly take secretions or sputum for cultivation.

Differential diagnosis

Acinetobacter pneumonia is very difficult to distinguish from other Gram-negative bacteria pneumonia, unless the clinical manifestations are typical P. aeruginosa or E. coli infection of characteristic sputum, such as bacterial growth in the presence of other Gram-negative bacteria, may For mixed infection, the number of bacteria should be used to determine whether there is Acinetobacter infection.

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