实用心脑肺血管病杂志
實用心腦肺血管病雜誌
실용심뇌폐혈관병잡지
Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease
2015年
10期
106-108
,共3页
医院获得性肺炎%肺炎克雷伯菌%碳青霉烯类%β-内酰胺/酶抑制剂
醫院穫得性肺炎%肺炎剋雷伯菌%碳青黴烯類%β-內酰胺/酶抑製劑
의원획득성폐염%폐염극뢰백균%탄청매희류%β-내선알/매억제제
Hospital-acquired pneumonia%Klebsiella pneumoniae%Carbapenem%Beta-lactama/enzyme inhibitors
目的：回顾性分析碳青霉烯类抗生素联合β-内酰胺/酶抑制剂治疗耐药肺炎克雷伯菌所致医院获得性肺炎（HAP）的疗效。方法选取2013年6月—2014年12月在解放军总医院确诊的耐药肺炎克雷伯菌所致 HAP 患者20例，分析其产超广谱β-内酰胺酶（产 ESBLs）菌株分布及耐药情况，并给予碳青霉烯类抗生素联合β-内酰胺/酶抑制剂治疗，观察治疗14 d 后临床疗效、治疗30 d 后病死率及治疗期间不良反应。结果20例患者中发现产 ESBLs菌株14例（占70%）；药敏试验结果显示，20株耐药肺炎克雷伯菌对青霉素类、β-内酰胺/酶抑制剂、碳青霉烯类、氨基糖苷类、喹诺酮类抗菌药物及复方磺胺甲噁唑片耐药率均在70%以上。患者治疗有效率为65%，病死率为35%，归因死亡率为20%，治疗期间出现轻微恶心、呕吐2例，皮疹2例，肠道二重感染4例。结论碳青霉烯类抗生素联合β-内酰胺/酶抑制剂治疗耐药肺炎克雷伯菌所致 HAP 安全有效。
目的：迴顧性分析碳青黴烯類抗生素聯閤β-內酰胺/酶抑製劑治療耐藥肺炎剋雷伯菌所緻醫院穫得性肺炎（HAP）的療效。方法選取2013年6月—2014年12月在解放軍總醫院確診的耐藥肺炎剋雷伯菌所緻 HAP 患者20例，分析其產超廣譜β-內酰胺酶（產 ESBLs）菌株分佈及耐藥情況，併給予碳青黴烯類抗生素聯閤β-內酰胺/酶抑製劑治療，觀察治療14 d 後臨床療效、治療30 d 後病死率及治療期間不良反應。結果20例患者中髮現產 ESBLs菌株14例（佔70%）；藥敏試驗結果顯示，20株耐藥肺炎剋雷伯菌對青黴素類、β-內酰胺/酶抑製劑、碳青黴烯類、氨基糖苷類、喹諾酮類抗菌藥物及複方磺胺甲噁唑片耐藥率均在70%以上。患者治療有效率為65%，病死率為35%，歸因死亡率為20%，治療期間齣現輕微噁心、嘔吐2例，皮疹2例，腸道二重感染4例。結論碳青黴烯類抗生素聯閤β-內酰胺/酶抑製劑治療耐藥肺炎剋雷伯菌所緻 HAP 安全有效。
목적：회고성분석탄청매희류항생소연합β-내선알/매억제제치료내약폐염극뢰백균소치의원획득성폐염（HAP）적료효。방법선취2013년6월—2014년12월재해방군총의원학진적내약폐염극뢰백균소치 HAP 환자20례，분석기산초엄보β-내선알매（산 ESBLs）균주분포급내약정황，병급여탄청매희류항생소연합β-내선알/매억제제치료，관찰치료14 d 후림상료효、치료30 d 후병사솔급치료기간불량반응。결과20례환자중발현산 ESBLs균주14례（점70%）；약민시험결과현시，20주내약폐염극뢰백균대청매소류、β-내선알/매억제제、탄청매희류、안기당감류、규낙동류항균약물급복방광알갑오서편내약솔균재70%이상。환자치료유효솔위65%，병사솔위35%，귀인사망솔위20%，치료기간출현경미악심、구토2례，피진2례，장도이중감염4례。결론탄청매희류항생소연합β-내선알/매억제제치료내약폐염극뢰백균소치 HAP 안전유효。
Objective To retrospectively analyze the clinical effect of carbapenems combined with β - lactam/ enzyme inhibitors on hospital - acquired pneumonia caused by drug - resistant Klebsiella pneumoniae. Methods A total of 20 patients with hospital - acquired pneumonia caused by drug - resistant klebsiella pneumoniae were selected in General Hospital of the Chinese People's Liberation Army from June 2013 to December 2014,positive rate of bacterial strains with ESBLs and incidence of drug resistance were analyzed;all of the 20 patients received carbapenems combined with β - lactam/ enzyme inhibitors, clinical effect after 14 days of treatment,fatality rate after 30 days of treatment and incidence of adverse reactions during treatment were observed. Results A total of 14 bacterial strains with ESBLs were found( accounted for 70% ),the drug resistant rates of Klebsiella pneumoniae to penicillins, β - lactam/ enzyme inhibitors, carbapenems, aminoglycosides, quinolones and trimethoprim/ sulfamethoxazole were all over 70% . The effective rate was 65% , fatality rate was 35% , attribution mortality was 20% . During treatment,2 cases occurred mild nausea and vomiting,2 cases occurred rash,4 cases occurred intestinal double infection. Conclusion Carbapenems combined with β - lactam/ enzyme inhibitors is effective and safe in treating hospital - acquired pneumonia caused by drug - resistant Klebsiella pneumoniae.
