院内产超广谱β-内酰胺酶的大肠埃希菌、肺炎克雷伯菌感染临床用药分析

Clinical Medication for Infections Caused by ESBLs-producing Escherichia coli and Kalispell Pneumonia

目的:了解院内产超广谱β-内酰胺酶(ESBLs)的大肠埃希菌、肺炎克雷伯菌感染的临床用药情况。方法:对我院2005年460株产ESBLs的大肠埃希菌、肺炎克雷伯菌的药敏情况及抗生素应用情况进行回顾性分析。结果:我院产ESBLs的大肠埃希菌和肺炎克雷伯菌感染主要集中在呼吸科、重症监护病房及神经外科。经验用药应用最多的是左氧氟沙星,其次为头孢哌酮/舒巴坦;药敏报告后用药主要为碳青霉烯类,其次为左氧氟沙星及头孢哌酮/舒巴坦。药物联用以二联应用为主,最多达六联。结论:我院治疗用药中大部分是有效合理的,但也存在不合理、不规范应用现象,应引起重视。

OBJECTIVE： To study the hospital infections caused by ESBLs - producing Escherichia coli and Kalispell. METHODS： Bacterial drug resistance of 460 stains of ESBLs- producing Escherichia coli and Kalispell pneumonia and the application of antibiotics in our hospital in 2005 were analyzed retrospectively. RESULTS： The infections caused by ESBLs- producing Escherichia coli and Kalispell pneumonia were more often found in department of respiratory diseases, ICU and neurosurgery patients, which were treated empirically predominantly with levofloxacin, followed by cefoperazone/sulbactam, but were treated mostly by carbapenems, levofloxacin, cefoperazone/ sulbactam after the drug susceptibility test results were obtained. The drug combination was characterized predominantly by combined use of two kinds, at most 6 kinds in combination. CONCLUSION： In most of the cases the medication for infections caused by ESBLs - producing Escherichia coli and Kalispell pneumonia is effective and reasonable. However, in a few cases the application of antibiotics is irrational and nonstandard, which should be given fully attention.