哌拉西林-他唑巴坦治疗产ESBLs细菌感染134例  

Efficacy of piperacillin-tazobactam in the treatment of 134 cases of bacterial infections caused by ESBLs-producing strains

作　　者：李惠[1] 宋珍[1] 倪语星[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院检验系临床微生物学教研室,200025

出　　处：《中国感染与化疗杂志》2010年第2期90-93,共4页Chinese Journal of Infection and Chemotherapy

摘　　要：目的了解产ESBLs细菌对哌拉西林-他唑巴坦的体外敏感性与该药物治疗产ESBLs菌株感染的临床疗效。方法采用CLSI推荐的ESBLs初筛和确证实验方法,收集各研究中心从临床送检的各类标本中分离出的产ESBLs菌株共134株,进行哌拉西林-他唑巴坦体外药敏试验及患者的临床用药治疗评价。结果可行最终评价的120例患者,感染产ESBLs菌株中大肠埃希菌为82例,肺炎克雷伯菌为38例。经治疗后,有效率为91.7%(110/120),无效率为8.3%(10/120)。感染部位以肺炎最为多见,共59例,有效率为88.1%(52/59),无效率为11.9%(7/59)。可行细菌学疗效评价的菌株,细菌清除率为82.5%,未清除的21株中3例由敏感转变为耐药。结论哌拉西林-他唑巴坦对产ESBLs的大肠埃希菌和肺炎克雷伯菌均有较好的抗菌活性,可用于临床治疗产ESBLs菌引起的感染性疾病。Objective To investigate the susceptibility of ESBLs-producing pathogens to piperacillin-tazobactam（PTZ）and the efficacy of PTZ in the treatment of infections caused by ESBL-producing strains.Methods The ESBLs screening and confirmatory tests recommended by CLSI were used to identify the 134 ESBLs-producing strains isolated from patients.The antimicrobial susceptibility of ESBL-producing strains to PTZ and the clinical outcomes were evaluated.All statistical analyses were conducted using WHONET version 5.3 and McNemar＇s test.Results Of the 120 evaluable patients,82 were infected with ESBLs-producing E.coli and 38 with ESBLs-producing K.pneumoniae.The clinical efficacy of PTZ was 91.7%（110/120）.Treatment failure was found in 10（8.3%）of the 120 patients.The clinical efficacy and failure rates were 88.1%（52/59）and 11.9%（7/59）respectively in the 59 pneumonia patients.The bacterial eradication rate was 82.5% in all microbiologically evaluable strains.Of the 21 persistent ESBL-producing strains after PTZ therapy,3 changed from sensitive to resistant.Conclusions ESBLs-producing E.coli and K.pneumoniae are highly susceptible to PTZ.PTZ is suitable for treatment of infections caused by ESBL-producing strains.

关 键 词：大肠埃希菌 肺炎克雷伯菌 超广谱Β内酰胺酶 哌拉西林-他唑巴坦 

分 类 号：R516[医药卫生—内科学]