發(fā)布時(shí)間：2018-04-28 10:12

  本文選題：肝硬化 + 革蘭陰性菌��； 參考：《中華醫(yī)院感染學(xué)雜志》2017年09期

【摘要】：目的分析肝硬化患者院內(nèi)革蘭陰性菌血流感染的病原菌特征并探索最佳治療策略。方法采取回顧性研究方法,選取2010年1月-2015年12月入住解放軍第302醫(yī)院發(fā)生院內(nèi)血流感染的肝硬化患者344例為研究對(duì)象,統(tǒng)計(jì)分析臨床特點(diǎn)、病原菌分布及藥敏情況。結(jié)果總體臨床好轉(zhuǎn)率66.9%,無效/病死率為33.1%;患者院內(nèi)血流感染發(fā)生后,≤12h應(yīng)用敏感抗菌藥物的好轉(zhuǎn)率74.0%,明顯高于12h使用敏感抗菌藥物者(53.0%),差異有統(tǒng)計(jì)學(xué)意義(P0.01);Child-Pugh分級(jí)越高,12h使用敏感抗菌藥物好轉(zhuǎn)率越低,差異有統(tǒng)計(jì)學(xué)意義(P0.05);共分離出革蘭陰性菌360株,前6位依次為大腸埃希菌159株(44.2%)、肺炎克雷伯菌59株(16.4%)、鮑氏不動(dòng)桿菌27株(7.5%)、陰溝腸桿菌18株(5.0%)、氣單胞菌16株(4.4%)、銅綠假單胞菌12株(3.3%);總體敏感性較高的抗菌藥物分別是美羅培南94.0%、阿米卡星93.9%、亞胺培南91.0%、頭孢美唑86.9%、哌拉西林/他唑巴坦86.3%、頭孢哌酮/舒巴坦84.2%;不同細(xì)菌對(duì)抗菌藥物的敏感性存在差異。結(jié)論肝硬化患者一旦發(fā)生院內(nèi)血流感染,應(yīng)盡早應(yīng)用敏感性高的抗菌藥物進(jìn)行治療,頭孢哌酮/舒巴坦、哌拉西林/他唑巴坦、亞胺培南、美羅培南、阿米卡星等抗菌藥物可作為一線經(jīng)驗(yàn)用藥,必要時(shí)需考慮聯(lián)合用藥。
[Abstract]:Objective to analyze the pathogenic bacteria characteristics of Gram-negative bacteria in hospital blood stream infection in patients with liver cirrhosis and to explore the best treatment strategy. Methods A retrospective study was carried out in 344 patients with blood flow infection in hospital from January 2010 to December 2015 in 302 Hospital of PLA. The clinical characteristics, distribution of pathogenic bacteria and drug sensitivity were analyzed statistically. Results the overall clinical improvement rate was 66.9% and the invalid / mortality rate was 33.1.After the occurrence of nosocomial blood flow infection, The improvement rate of sensitive antimicrobial agents in 鈮，

本文編號(hào)：1814829