中国老年保健医学
中國老年保健醫學
중국노년보건의학
CHINESE JOURNAL OF GERIATRIC CARE
2014年
3期
45-47,48
,共4页
王志宏%何宏%樊明超%姜云霞%李连弟
王誌宏%何宏%樊明超%薑雲霞%李連弟
왕지굉%하굉%번명초%강운하%리련제
β-内酰胺酶类%哌拉西林-他唑巴坦%寄殖%头孢菌素类
β-內酰胺酶類%哌拉西林-他唑巴坦%寄殖%頭孢菌素類
β-내선알매류%고랍서림-타서파탄%기식%두포균소류
Β-lactamase%Piperacillin-Tazobactam%Permanent Planting%Cephalosporin
目的：研究哌拉西林-他唑巴坦替换第三代头孢菌素应用于神经ICU患者的临床价值，探讨其对产ESBLs菌株医院感染发生的影响。方法在哌拉西林-他唑巴坦临床干预前后，检测患者直肠拭子存在产ESBLs的大肠埃希菌，肺炎克雷伯杆菌的情况，比较前后两阶段的产ESBLs细菌的临床寄殖率；并对哌拉西林-他唑巴坦临床干预前后患者的气道分泌物进行培养鉴定、分析药物敏感性，比较前后两阶段产ESBLs细菌发生率变化。结果哌拉西林-他唑巴坦干预后，大肠埃希菌，肺炎克雷伯杆菌产ESBLs菌寄殖率从33.3％降至18.8％（ P＜0.05）。产ESBLs肺炎克雷伯杆菌比率从72.2％降至50％（P＜0.05），产ESBLs大肠埃希菌比率从75％降至39.58％（P＜0.05）。结论在神经ICU病区使用哌拉西林-他唑巴坦替换第三代头孢菌素可降低单元内产ESBLs细菌临床寄殖率，降低产ESBLs菌比率。
目的：研究哌拉西林-他唑巴坦替換第三代頭孢菌素應用于神經ICU患者的臨床價值，探討其對產ESBLs菌株醫院感染髮生的影響。方法在哌拉西林-他唑巴坦臨床榦預前後，檢測患者直腸拭子存在產ESBLs的大腸埃希菌，肺炎剋雷伯桿菌的情況，比較前後兩階段的產ESBLs細菌的臨床寄殖率；併對哌拉西林-他唑巴坦臨床榦預前後患者的氣道分泌物進行培養鑒定、分析藥物敏感性，比較前後兩階段產ESBLs細菌髮生率變化。結果哌拉西林-他唑巴坦榦預後，大腸埃希菌，肺炎剋雷伯桿菌產ESBLs菌寄殖率從33.3％降至18.8％（ P＜0.05）。產ESBLs肺炎剋雷伯桿菌比率從72.2％降至50％（P＜0.05），產ESBLs大腸埃希菌比率從75％降至39.58％（P＜0.05）。結論在神經ICU病區使用哌拉西林-他唑巴坦替換第三代頭孢菌素可降低單元內產ESBLs細菌臨床寄殖率，降低產ESBLs菌比率。
목적：연구고랍서림-타서파탄체환제삼대두포균소응용우신경ICU환자적림상개치，탐토기대산ESBLs균주의원감염발생적영향。방법재고랍서림-타서파탄림상간예전후，검측환자직장식자존재산ESBLs적대장애희균，폐염극뢰백간균적정황，비교전후량계단적산ESBLs세균적림상기식솔；병대고랍서림-타서파탄림상간예전후환자적기도분비물진행배양감정、분석약물민감성，비교전후량계단산ESBLs세균발생솔변화。결과고랍서림-타서파탄간예후，대장애희균，폐염극뢰백간균산ESBLs균기식솔종33.3％강지18.8％（ P＜0.05）。산ESBLs폐염극뢰백간균비솔종72.2％강지50％（P＜0.05），산ESBLs대장애희균비솔종75％강지39.58％（P＜0.05）。결론재신경ICU병구사용고랍서림-타서파탄체환제삼대두포균소가강저단원내산ESBLs세균림상기식솔，강저산ESBLs균비솔。
Objective The aim of this study was to clarify the effect of ESBL (+) bacterium under the replacement of third generation cephalosporin by in Neurosurgical Intensive Care Unit.Methods We tested the quantity of ESBL ( +) bacterium ( Escherichia coli and Klebsiella pneumoniae ) , and compared the rate of proliferation before and after using Piperacillin-Tazobac-tam;Likewise we cultivated the production of patients'airway before and after using Piperacillin-Tazobactam, and the bacterium were isolated for drug sensitivity test , to analysis the rate of ESBL (+) bacterium in these two periods.Results After using Piperacillin-Tazobactam, the proliferation rate of ESBL (+) bacterium degraded from 33.3%to 18.8%.(P<0.05).The proliferation rate of ESBL (+) Klebsiella pneumoniae decreased from 72.2%to 50%(P<0.05), this rate of ESBL (+) Escherichia coli degraded from 72.2%to 50%(P<0.05).Conclusion Replacement of third generation cephalosporin by Piperacillin-Tazobactam could de-grade the rate of ESBL (+) bacterium in Neurosurgical Intensive Care Unit.
