1例老年瘫痪患者并发耐碳青霉烯肺炎克雷伯菌所致复杂性尿路感染分析  

Analysis of the Anti⁃infection Strategies for Recurrent Urinary Tract Infections Caused by Carbapenem⁃resistant Klebsiella Pneumoniae in a Senile Paralysis Patient

作　　者：孙强 李忠东 Sun Qiang;Li Zhongdong(Department of Pharmacy,Electric Power Teaching Hospital of Capital Medical University(Beijing Electric Power Hospital of State Grid Corporation of China),Beijing 100073,China)

机构地区：[1]国家电网公司北京电力医院首都医科大学电力教学医院药剂科,北京100073

出　　处：《药物流行病学杂志》2022年第12期836-840,共5页Chinese Journal of Pharmacoepidemiology

摘　　要：本文介绍临床药师参与治疗1例老年女性瘫痪患者并发耐碳青霉烯肺炎克雷伯菌(CR⁃KP)所致复杂尿路感染的治疗思路,为类似抗感染药学服务提供参考。患者为反复发作的复杂性尿路感染(UTI),治疗过程中尿液反复检测出CR⁃KP,临床药师参与会诊多次,根据耐药菌特点、临床指南结合自身的临床治疗经验遴选合适的抗感染药物,先后制定了以磷霉素为基础的3套抗感染方案,并实施临床药学监护。患者最终中段尿培养阴性,炎性指标明显好转,生命体征趋于平稳,顺利出院。临床药师深入临床,参与临床治疗方案的优化,可加速患者疾病的康复。The strategies for the clinical pharmacists participating in the treatment of complex urinary tract infec⁃tions(UTI)caused by the complications of carbapenem⁃resistant Klebsiella pneumoniae(CR⁃KP)in an old woman with paralysis were introduced,so as to provide reference for the similar anti⁃infection pharmaceutical services.As the patient had a complex recurrent urinary tract infection,carbapenem⁃resistant Klebsiella pneumoniae were repeatedly detected in her urine samples during the treatment.The clinical pharmacists participated in 5 consultations,formulated 3 anti⁃infection reg⁃imens based on fosfomycin,and performed the clinical pharmaceutical care according to the characteristics of drug⁃resistant bacteria and the latest clinical guidelines combined with their own clinical treatment experience to select appropriate anti⁃in⁃fective drugs.Eventually,the patient’s mid⁃portion urine culture grew negative.The patient’s inflammatory indexes were significantly improved.The patient’s vital signs returned to be stable(pulse rate,respiration rate,body temperature,blood pressure),and successfully discharged from hospital.Repeated participation of clinical pharmacists in clinical practice and optimization of clinical therapeutic regimens can accelerate patients’rehabilitation.

关 键 词：耐碳青霉烯类肺炎克雷伯菌 尿路感染 瘫痪 磷霉素 药学监护 

分 类 号：R97[医药卫生—药品]