呼吸道病患产ESBLs菌株的药敏试验情况及应用亚胺培南的效果研究  

Drug Sensitivity Test of ESBLs-producing Strains in Respiratory Tract Diseases and the Effect of Imipenem

作　　者：袁海燕[1] Haiyan YUAN(Department of Clinical Laboratory,Taixing People's Hospital of Jiangsu Province,Taixing Jiangsu 225400,China)

机构地区：[1]江苏省泰兴市人民医院检验科

出　　处：《国际感染病学（电子版）》2019年第4期216-218,共3页Infection International(Electronic Edition)

摘　　要：目的研究呼吸道病患产ESBLs菌株的药敏试验情况及应用亚胺培南的效果.方法研究对象为本院2016年7月-2018年12月住院的呼吸道感染患者120例,按照随机数字表将以上患者随机分为两组,分别为观察组和对照组,每组患者60例,分析患者的痰标本革兰氏阴性菌的分布情况以及产ESBLs菌患者的耐药情况,观察组患者采取亚胺培南治疗,对照组采取左氧氟沙星治疗,分析两组患者的治疗效果、临床症状改善情况、血气指标以及不良反应之间的差异.结果肺炎克雷伯菌93例、大肠埃希菌45例,奇异变形杆菌33例以及其他菌种5例.其中,共计发现产ESBLs菌60例,产ESBLs菌患者对左氧氟沙星的耐药情况较为严重,观察组患者的治疗效果(90.00%)显著高于对照组,观察组患者的止咳时间、肺部哮鸣音消失时间以及退热时间显著低于对照组,治疗前,两组患者的PH、PCO2、HCO3-之间的差异不存在统计学意义(P>0.05),经过治疗后,两组患者的PH、PCO2、HCO3-均显著改善,且观察组患者的PH均显著高于对照组,观察组患者的PCO2、HCO3-显著低于对照组,两组患者并未出现不良反应.结论产ESBLs菌患者对左氧氟沙星的耐药情况较为严重,在日后的治疗中,以上抗生素不建议作为首选.同时,亚胺培南较好的临床效果以及安全性,建议临床推广.Objective To study the drug sensitivity test of ESBLs producing strains in respiratory diseases and the effect of azithromycin application. Methods The subjects were 120 patients with respiratory tract infection hospitalized in our hospital from July 2016 to December 2018. According to the random number table, the patients were randomly divided into two groups: observation group and control group, 60 cases in each group. The distribution of Gram-negative bacteria in sputum samples and drug resistance of ESBLs-producing patients were analyzed. The observation group was treated with azithromycin, while the control group was treated with imipenem. The difference of therapeutic effect, clinical symptoms improvement, blood gas index and adverse reactions between the two groups was analyzed. Results There were 93 cases of Klebsiella pneumoniae, 45 cases of Escherichia coli, 33 cases of Proteus mirabilis and 5 cases of other bacteria. Among them, 60 cases of ESBLs-producing bacteria were found. The resistance of ESBLs-producing patients to Biancacillin, Amoxicillin and Ceftriaxone was more serious. The therapeutic effect of the observation group(90.00%) was significantly higher than that of the control group. The antitussive time, the disappearance time of wheezing sound and the antipyretic time of the observation group were significantly lower than those of the control group. Before treatment, there was no significant difference in PH, PCO 2 and HCO 3-between the two groups(P > 0.05). After treatment, the PH, PCO 2 and HCO 3-of the two groups were significantly improved, and the PH of the observation group was significantly higher than that of the control group, while the PCO 2 and HCO 3-of the observation group were significantly lower than that of the control group. The two groups of patients did not show any difference. Conclusion The resistance of ESBLs-producing patients to Biancacillin, Amoxicillin and Ceftriaxone is more serious. In future treatment, the above antibiotics are not recommended as the first choice.

关 键 词：亚胺培南 耐药性 产ESBLS菌 临床症状改善 呼吸道感染 

分 类 号：R44[医药卫生—诊断学]