头孢类抗菌药物致肠道菌群失调的调查

Investigation and analysis of intestinal flora imbalance induced by use of cephalosporin antibiotics

目的了解临床患者使用头孢类抗菌药物后肠道菌群的改变,探讨临床患者的肠道菌群受头孢类抗菌药物的影响,从而合理使用头孢类抗菌药物。方法随机抽取消化科50例口服头孢类抗菌药物>5d的住院患者为研究对象,对照组为同期健康体检人员,共20名;均采集新鲜粪便直接涂片作革兰染色并镜检,记录每份标本中革兰阴性杆菌、革兰阳性杆菌及革兰阳性球菌所占比例。结果试验组革兰阴性杆菌、革兰阳性杆菌、革兰阳性球菌异常率分别为90.0%、82.0%和56.0%;对照组分别为15.0%、10.0%和15.0%,两组比较差异有统计学意义(P<0.01);试验组粪便菌群Ⅰ、Ⅱ、Ⅲ度失调分别占22.0%、50.0%、12.%,对照组分别占5.0%、0、0。结论头孢类抗菌药物的使用对人体肠道菌群的数量及结构影响明显,且对革兰阴性杆菌及革兰阳性杆菌的影响作用大于革兰阳性球菌。

OBJECTIVE To observe the change of intestinal flora in,the clinical patients who used cephalosporin antibiotics and explore the effect Of the cephalosporin antibiotics on the intestinal flora so as to reasonably use the cephalosporin antibiotics. METHODS A ＇total of 50 patients who were hospitalized the gastroenterology department and given oral administration of cephalosporin antibiotics for more than 5 days were recruited as the study objects, meanwhile, 20 healthy people who underwent physical examination were assigned as the control group, then the fresh stool specimens were sampled for gram staining and microscopic examination through direct smearing, and the proportions of gram-negative bacilli, gram-positive bacilli, and gram-positive cocci taken in each sample were recorded. RESULTS The abnormal rates of the gram-negative bacilli, gram-positive bacilli, and gram-positive cocci were respectively 90.0%, 82.0%, and 56.0% in the experimental group and were respectively 15.0%, 10.0%, and 15.0% in the control group, and there were statistically significant differences between the two groups （P〈0.01）. The patients with stool flora imbalance Ⅰ accounted for 22. 0% in the experimental group, 5.0% in the control group; the patients with stool flora imbalance Ⅱ accounted for 50.0% in the experimental group, 0 in the control group; the patients with stool flora imbalance m accounted for 12.%in the experimental group, 0 in the control group. CONCLUSION The use of cephalosporin antibiotics has significant effect on the flora counts and structure of the intestinal flora and has more significant effect on the gram-negative bacilli and gram-positive bacilli than on the gram-positive cocci.