医院感染病原菌药敏试验指导抗感染治疗价值  

Value of Drug Sensitive Test of Nosocomial Infection Bacteria to Anti-infectious Treatment

作　　者：周瑞微[1] 陈文俊[1] 徐莹玲[1] 陈谦[1] 郑维锷[1] 张武[1] 王琼[1] 

机构地区：[1]瑞安市人民医院温州医学院附属三院感染管理科,浙江瑞安325200

出　　处：《中华医院感染学杂志》2008年第2期256-258,共3页Chinese Journal of Nosocomiology

摘　　要：目的探讨恶性肿瘤患者医院感染应用上年度病原菌药敏试验结果,指导本年度经验性抗感染治疗首选药物选择的价值。方法在无2002年药敏结果做参考的情况下,2003年初次经验性治疗方案为"经典"的头孢他啶方案;2004年初次方案根据2003年药敏结果,确立为哌拉西林/他唑巴坦并同时与头孢他啶方案作随机对比。结果头孢他啶方案在2003、2004年有效率分别为43.8%、46.7%,与两者当年度的敏感性覆盖率54.5%、59.0%吻合(P>0.05);根据药敏结果选定的哌拉西林/他唑巴坦方案,其有效率明显高于对照组及2003年治疗组,分别为86.2%对46.7%(P<0.05)及86.2%对43.8%(P<0.05),与两者的敏感性覆盖率85.2%对54.5%相吻合(P>0.05);2005、2006年头孢哌酮/舒巴坦方案有效率分别为83.6%、85.2%,分别与2004、2005年其敏感性覆盖率81.3%、89.3%相符(P>0.05)。结论上一年度医院感染病原菌药敏试验结果,对次年度经验性抗感染治疗首选药物的选择有指导意义。OBJECTIVE To investigate the value of drug sensitive test of preceded year for primary empirical antiinfectious treatment of nosocomial infection among malignant tumor patients. METHODS Without the results of drug sensitive test in 2002, we used classical cefradine scheme in 2003, while in 2004 we chose the scheme of piperacillin and tazobactam according to the drug sensitive test of 2003, with the contrast of cefradine scheme. RESULTS The effective rate of cefradine scheme in 2003 and 2004 was 43.8% and 46.7% ,and they both accorded with the sensitivity cover rate of these two years respectively （P 〉0. 05）. The effective rate of scheme of piperacillin and tazobactam was much higher than the control group and treatment group in 2003, 86.2% with 46.7%（P〈0.05） and 86.2% with 43.8% （P%0.05）, and also both accorded with these two years sensitivity cover rate, 85.2% with 54.5%（P〉0.05）. The effective rate of scheme of eefoperazone and sulhaetam in 2005 and 2006 was 83.6% and 85.2%,which accorded with the sensitivity cover rate 81.3% and 89.3% in 2004 and 2005, respectively（P〉0.05）. CONCLUSIONS Drug sensitive test of preceded year has directive significance for primary empirical anti-infectious treatment of nosocomial infection among malignant tumor patients.

关 键 词：医院感染 病原菌药敏试验 经验性抗感染治疗 临床价值 

分 类 号：R978.1[医药卫生—药品]