临床抗感染治疗不足与耐药菌产生的相关研究

Correlation between insufficient clinical anti-infection treatment and emergence of drug-resistant bacteria

目的探讨临床抗感染治疗不足与耐药菌产生的相关性,指导临床抗感染治疗以及减少耐药菌的产生。方法选取医院2013年9月-2014年1月140例感染性疾病住院患者,将患者均分为试验组和对照组,各70例;其中对照组为抗感染不足患者,采用药物最低抑菌浓度(MIC)的剂量治疗,试验组为治疗充足患者,采用药物防突变浓度(MPC)的剂量治疗;比较两组患者用药后3、6d的白细胞(WBC)计数和治疗后耐药菌产生情况。结果试验组3d后WBC计数为(8.308±0.785)×109/L,6d后WBC计数为(7.986±1.151)×109/L,WBC增值为(-0.391±1.237)×109/L,低于治疗不足组的(9.172±0.799)×109/L、(11.123±1.039)×109/L及(2.381±2.134)×109/L,两组比较差异有统计学意义(P<0.05);试验组患者产生耐药菌125株,对照组产生耐药菌824株,两组比较差异有统计学意义(P<0.05)。结论临床中抗感染治疗不足可导致耐药菌的产生,采用高浓度的MPC治疗剂量在抗感染治疗上的效果优于较低浓度的MIC治疗剂量,能有效减少因抗感染治疗不足而导致的耐药菌产生。

OBJECTIVE To explore the relationship between the insufficient clinical anti-infection treatment and the emergence of drug-resistant bacteria so as to provide guidance for clinical treatment of infections and prevent the emergence of drug-resistant bacteria.METHODS A total of 140 patients with infectious diseases who were hospitalized from Sep 2013 to Jan 2014 were enrolled in the study and divided into the experimental group and the control group,with 70 cases in each.The control group was treated with the dose of minimal inhibitory concentration（MIC）for the insufficient anti-infection treatment,while the experimental group was treated with the dose of mutant prevention concentration（MPC）.The white blood cells（WBC）counts and the emergence of drug-resistant bacteria were observed and compared between the two groups after the medication for 3and 6days.RESULTS The mean WBC counts of the experimental group was（8.308±0.785）×10^9/L after the medication for 3days,lower than（9.172±0.799）×10^9/L of the control group;the mean WBC counts of the experimental group was（7.986±1.151）×10^9/L after the medication for 6days,lower than（11.123±1.039）×10^9/L of the control group;the increase of the WBC counts of the experimental group was（-0.391±1.237）×10^9/L,lower than（2.381±2.134）×10^9/L of the control group;there was significant difference between the two groups（P〈0.05）.Totally 125 strains of drug-resistant bacteria emerged in the experimental group,and 824 strains of drug-resistant bacteria emerged in the control group,with significance（P〈0.05）.CONCLUSIONThe clinical insufficient anti-infection treatment may induce the emergence of drug-resistant bacteria.The high dose of MPC is superior to the low dose of MIC in the clinical treatment of infections,and it can effectively prevent the emergence of the drug-resistant bacteria due to the insufficient treatment.