免疫营养对重症急性胰腺炎细菌感染的菌谱及耐药性的影响  

Effects of immunonutrition to the pattern and resistance of bacteria isolated from complicated infections in patients with severe acute pancreatitis

作　　者：李青[1] 胡瑞钺[1] 

机构地区：[1]江西省人民医院药剂科,南昌330006

出　　处：《江西医药》2015年第8期731-733,共3页Jiangxi Medical Journal

基　　金：江西省卫生厅科技计划项目(20143010)

摘　　要：目的探讨免疫营养对重症急性胰腺炎(SAP)患者感染菌的菌群变化和耐药特征的影响。方法随机将68例SAP患者分为肠内免疫营养组(A组)和肠内标准营养组(B组),A组36例接受肠内免疫营养治疗,B组32例接受标准肠内营养治疗,均连续使用15d。统计上述SAP患者腹腔内胰腺与胰腺周围采集的病原菌菌群和耐药性变化。结果 A组共检出病原菌73株,革兰阴性菌57株,其中产ESBLs菌株14株,所占比率为24.6%;B组共检出病原菌75株,革兰阴性菌60株,其中产ESBLs菌株22株,所占比率为36.7%,与A组相比较其产ESBLs菌株的检出率显著增加(P<0.05)。结论重症急性胰腺炎细菌感染以革兰阴性菌为主,免疫营养可以有效降低重症急性胰腺炎细菌感染中产ESBLs菌株的分布。Objective To investigate the effects of immunonutrition changing pattern of pathogen strains and their resistance to antimicrobial agents in patients with severe acute pancreatitis（SAP）. Methods 68 SAP patients were randomly divided into enteral immunonutrition feeding group（A group） and standard enteral nutrition group（B group）. 36 patients in A group received enteral nutrition enriched with arginine and glutamine,while the other 32 patients in B group received a standard enteral nutrition. Nutritional support was continued for 15 days,analyzed in order to understand the changing pattern of pathogen strains and their resistance to antimicrobial agents. Results There were 73 pathogens be detected in A group,57（78.1%） were gram-negative bacteria;including 14 ESBLs-positive pathogens,（24.6%）. 75 pathogens be detected in B group,60（80%） were gram-negative bacteria; including 22 ESBLs-positive pathogens（36.7%）. Incidence of ESBLs-positive pathogens in A group was significant decreased than B group（P〈0.05）. Conclusion Gram-negative bacteria are the major pathogens of infection in SAP patients. Immunonutrition can reduce the incidence of ESBLs-positive pathogens significantly.

关 键 词：重症急性胰腺炎 免疫营养 感染 病原菌 

分 类 号：R576[医药卫生—消化系统]