双歧杆菌对严重烧伤患者美罗培南应用后肠菌群的调节  

Effect of Bifidobacteria Preparation on Restoring the Disorder of Intestinal Microflora Induced by Meropenem in Severely Burned Patients

作　　者：王忠堂[1] 盛志勇[1] 蔡宝仁[2] 肖光夏[3] 王甲汉[3] 彭毅志[3] 罗奇志[3] 

机构地区：[1]军医进修学院304医院,北京100037 [2]解放军第205医院,辽宁锦州121001 [3]第三军医大学附属西南医院,重庆400038

出　　处：《中华医院感染学杂志》2004年第7期734-737,共4页Chinese Journal of Nosocomiology

基　　金："九五"军队攻关课题 (96 L 0 4 2 )

摘　　要：目的　探讨双歧杆菌对烧伤患者大剂量应用美罗培南后 ,紊乱肠菌群调整作用。方法　严重烧伤患者 2 3例应用美罗培南 (6 g/d) 7d后 ,随机分为治疗组 (n=11)和对照组 (n=12 ) ;双盲法给予双歧杆菌悬液和生理盐水 (10 0 ml/d) ,疗程 5 d;分别于美罗培南应用前及用后 0、1、3、5 d,常规方法检测粪便中双歧杆菌、真菌、大肠埃希菌量。结果　美罗培南应用 7d,肠道菌群中双歧杆菌量骤减近 10 0倍 ,真菌数激增 10 0倍 ;双歧杆菌治疗 1d,肠道双歧杆菌数增加 10 0倍 ,3d后真菌量减少约 2 5倍 ;对照组在停用美罗培南后 5 d肠道菌群始基本恢复 ;腹泻患者口服双歧杆菌后 3d肠道菌群恢复 ,对照组 5 d恢复。结论　长期大剂量应用美罗培南可导致肠道菌群紊乱 ,停药后外源性补充双歧杆菌能较快恢复肠道生态 ,治愈抗菌药物相关性腹泻。OBJECTIVE To evaluate the effect of bifidobacteria preparation on restoring intestinal microbial flora of severely burned patients after treatment with high dose meropenem. METHODS Severely burned patients were enrolled after treatment with meropenem (6 g/d) for 7 days, and divided into bifidobacteria treatment group (n=11) and placebo control group (n=12), randomly. Patients were taken orally bifidobacteria preparation (6×10~9 CFU/ml) in treatment group or normal saline in control one, thrice a day for 5 days in a double blind manner, in dose of 100 ml/d, post-prandially. Stool samples were collected from patients before the treatment with meropenem, and 0, 1, 3 and 5 days after that. The counts of bifidobacteria and fungi, as well as Escherichia coli, were detected by routine cultural technique. The clinical symptoms were recorded everyday. RESULTS After treated with meropenem for 7 days, there were significant changes in intestinal flora in all patients. The counts of bifidobacteria decreased by 100-fold,E. coli altered lightly, and fungi increased by 100-fold. Therefore, the ratio of bifidobacteria to E. coli changed from 100∶1 to 10∶1. Moreover, severely diarrhea cured (7/23). The intestinal microflora restored slowly, and diarrhea (n=4) ceased at the fifth day in normal saline group. However, intestinal flora restored, and diarrhea (n=3) ceased after 3-day bifidobacteria-supplemented formula. In contrast to placebo group, there were more bifidobacteria and less fungi at the first and third day in bifidobacteria treatment group. After treated with meropenem, disorder of GI tract microbial flora was more severely in diarrhea patients than that of in non-diarrhea patients, and the microbial flora in diarrhea patients restored more quickly in bifidobacteria treated group than that of in placebo control one. CONCLUSIONS Disorder of the intestinal tract flora promoted greatly by using high-efficiency and broad-spectrum antibiotics, and bifidobacteria preparation could restore the microbial flora more quickly

关 键 词：烧伤 美罗培南 肠道菌群 双歧杆菌属 抗菌药物相关性腹泻 

分 类 号：R977[医药卫生—药品]