Antimicrobial Therapy For Hospital Acquired Pneumonia Caused By Carbapanem-resistant Acinetobacter Baumannii In The Elderly

(95.0%),未扩增出OXA-24、OXA-58、SIM、VIM及IMP耐药基因。4、结论：(1)CRAB所致老年患者HAP的死亡预后与APACHEⅡ评分有关；CFS治疗CRAB的老年HAP有一定疗效。(2)CFS与RFP、MIN、MER及MER与MIN联用时对CRAB效应主要表现为协同和相加作用。CFS与LEV联用主要表现为无关作用,但仍有一部分表现为协同和相加作用。(3)我院流行的CRAB的碳青霉烯酶基因型主要为OXA-23和OXA-51型。 Cefoperazone/sulbactam was combined with Rifampicin, there were80.0%synergism,16.7%additive,3.3%indifference and no antagonism. When Cefoperazone/sulbactamwas combined with Minocycline, there were11.7%synergism,45.0%additive,35.0%indifference,and8.3%antagonism. When Cefoperazone/sulbactam was combined withLevofloxacin, there were6.7%synergism,40.0%additive,53.3%indifference, and noantagonism. When Cefoperazone/sulbactam was combined with Meropenem, there were28.3%synergism,53.4%additive,18.3%indifference and no antagonism.WhenMeropenem was combined with Minocycline, there were10.0%synergism,75.0%additive,15.0%indifference and no antagonism.(3) OXA-23and OXA-51gene wasdetected in58strains respectively(96.7%). Both OXA-23and OXA-51genes werefound in57strains(95.0%). OXA-24, OXA-58, SIM, VIM and IMP genes were notdetected in all strains.4. Conclusions:(1) APACHEⅡscore could be a predictive factor in elderly patientswith HAP caused by CRAB. Cefoperazone/sulbactum was effective in the treatment ofHAP patients caused by CRAB.(2) When Cefoperazone/sulbactam was co mbined withRifampicin, Minocycline, Meropenem or Meropenem was combined with M inocycline,the interaction was mainly synergism and additive. When Cefoperazone/sulbactam wascombined with Levofloxacin, the interaction was mainly indifference, but some strainsstill showed synergism and additive.(3) The main carbapenemases genes in our hospitalwere OXA-23and OXA-51genes.