耐氯霉素伤寒42例临床观察

CLINICAL OBSERVATIONS ON 42 CASES OF CHLORAMPHENICOL-RESISTANT TYPHOID FEVER

本文报道我院1978年6月～1988年12月收治的42例耐氯霉素伤寒的临床观察结果,发现耐氯霉素伤寒有如下临床特点:(1)多数为急性或亚急性起病;(2)以不规则热型为主;(3)全身中毒症状较重;(4)症状不典型者较多;(5)并发症与夹杂感染的发生率较高;(6)病程较长。耐氯霉素伤寒杆菌多数为多元耐药菌,本组分离菌株耐SMZ92.3％、耐TMP70％、耐头孢唑啉84.9％。本文并就耐氯霉素伤寒的诊断和治疗等问题进行了讨论。

Clinical observations on 42 cases of chloramphe nicol-resistant typhoid fever are presented. All the cases were confirmed by bacterial cultivation. Clinically the following observations were noteworthy: (1) the onset was acute or subacute in 61.9%;(2) 57.1% of cases had an irregular fever, ( 3 ) severe general symptoms of intoxication were noted in 92.9%; ( 4 ) symptoms were not characteristic in 78.6%;(5) complications and secondary infections were common; ( 6 ) the course was longer as compared with that of the general typhoid fever. Most chloramphenicol-resista nt typhoid bacilli were multi esistant, 92.3% of them being resistant to SMZ, 70% resistant to TMP, 84.9% resistant to cefazolin, and 88.1% resistant at least to 3 kinds of antibiotic. The diagnosis and treatment about chloramphenicol-resistant typhoid fever arc also discussed