Gram-negative bacilli pneumonia

Outlined within the hospital for pneumonia more Gram-negative bacteria caused, including pneumoniae, Pseudomonas aeruginosa, Haemophilus influenzae, E. coli, were 95.00, in derogation immunity facilitate incidence. The use of mechanical respiratory patients and humidification devices, nebulizers and catheter may lead to various bacterial infections. In addition, lung Tienam bacteremia may be forming bacteria spread to the lungs. Clinical manifestations of pulmonary Gram-negative bacteria infection is common lung disease or consolidation integration, necrosis easy multiple abscess formation, the general bilateral lower lobe more involvement; If the affected pleura, can cause pleural effusion or empyema. Diagnosis of sputum or blood from as training for pathogenic bacteria can be diagnosed. Sputum collected after 10 minutes of the inoculation training, many develop the same type of bacteria. Quantitative or sputum culture was more meaningful clinical diagnosis. To avoid oral always keep the bacteria pollution, can be used plastic catheter A film from the Central endotracheal suction, Bronchoscopy or suction from the lower respiratory tract through pollution prevention brush sampling for bacterial culture. Determination of serum antibodies contribute to the diagnosis. Pseudomonas aeruginosa Pseudomonas aeruginosa pneumonia serum agglutination test can be positive. Treatment of gram-negative bacteria should be made before the pneumonia bacteria sensitive tests to use effective drugs. Nosocomial infections in patients with severe pneumonia bacteria not clear before, try amino glycoside antibiotics plus semi-synthetic penicillin or cephalosporin (hospital infections can first trial ammonia penicillin G or benzyl - resistant : Inheritance-positive cocci more chances of infection). Pseudomonas aeruginosa pneumonia treatment mortality as high as 80%, appropriate use of antibiotics can Joint reduced to 50%. General semi-synthetic penicillin plus amino-glycosides antibiotics. Cerbencillin (carbenicllin) daily 20-30g of infusion, benzyl methyl resistant (Sulbenicillin) or Furbenicillin (furbenicillin) each Day 8 - 12g infusion, ticarcillin (ticarcillin) daily 10-ball infusion. And an amino-glycosides antibiotics (daily gentamicin 16 -24 10,000 units, Tobramycin daily or 240-GHSV), and with very good results. Right tobramycin resistant, can be used amikacin (amikacin) 0 .2-0.4 g daily, Note 2 hours, if drug resistance, other semi-synthetic penicillin can be chosen, piperacillin (piperacillin) daily 8 - 12g infusion, imidazole group of benzene and penicillin (mezlocillin). These new penicillin many have beta-lactamase Gram-negative bacilli effective. New penicillin antibiotics and amino glycoside combination can reduce resistance to emerge. Third-generation cephalosporins such as cefoperazone (cefiperazone) ceftazidime (ceftazidime) on Pseudomonas aeruginosa effective, and hard ammonia combined with antibiotics. Treatment of Haemophilus influenzae pneumonia, the first choice ampicillin (daily 4 - 6g, graded infusion); However, in view of this drug resistant strains of a growing, it prefers and chloramphenicol (1 - 2g daily) with, to be certified as bacteria do not produce beta-lactamase, it is solely with ampicillin (12 g daily intravenous). Erythromycin and amino glycoside antibiotics and drugs used in conjunction also synergies. When the infection is severe, and more than two pairs of bacterial drug resistance have, the choice of the third-generation cephalosporins such as cefuroxime, cephalosporins Cypriot oxime (cefoxitin), or Latamoxef (moxalactam). Treatment of bacterial pneumonia Enterobacteriaceae (such as E. coli, and gas production, bacillus cloacae caused), Reference should choose their drug susceptibility testing. Generally use ampicillin (daily 8 - 12g), cerbencillin (daily 8 - 12g). and an amino-glycosides and antibiotics combined. Can be combined with chloramphenicol and streptomycin. If necessary, use cefazolin, Cefadroxil - or cefotaxime. Ciprofloxacin right cloacae also a strong antibacterial effect. In the treatment of Gram-negative bacteria pneumonia, to high-dose, long course of treatment, combination, mainly intravenous infusion, supplemented by aerosol inhalation therapy; amino-glycosides use of antibiotics, to the attention of the right renal damage, we must also strengthen the patient's nutrition, fully to the water and drainage sputum.