检验师参与复杂肺部多重耐药菌感染治疗体会

Experience of laboratorians participation in the treatment of complex pulmonary multidrug resistant bacteria infection

目的探讨检验师在治疗复杂多重耐药菌感染中的作用。方法检验师参与2017年5月20日宜兴市第二人民医院收治的1例合并产超广谱β-内酰胺酶(ESBLs)肺炎克雷伯菌、肺炎支原体继发泛耐药鲍曼不动杆菌(XRAB)肺部感染者的治疗,向临床医师提供治疗方案,并评估临床疗效。结果根据药敏试验结果结合耐药机制分析,检验师建议采用大剂量亚胺培南(1.0 g/次、1次/6 h、静脉输注),同时延长静脉输注时间至2~3 h。经治疗后患者无发热、咳喘,血常规等指标恢复正常,细菌培养阴性。结论检验师参与临床抗感染治疗,为临床医师提供合理用药建议,有助于提高多重耐药菌感染的治愈率。

Objective To discuss the role of laboratorians in the treatment of complex multidrugresistant bacteria.Methods One laboratorians participated in the treatment of one patient admitted in Yixing No.2 People’s Hospital on May 20 th 2017 who was infected by Klebsiella pneumoniae carrying Extendedspectrumβ-lactamases(ESBLs),Mycoplasma pneumonia and extensively drug resistant Acinetobacter Bauman.Treatment was provided to clinicians and the clinical efficacy was evaluated.Results According to the drug sensitivity results and drug resistance mechanism analysis,the laboratorians suggested that high dose imipenem(intravenous drip 1.0 g every 6 hours)should be used and the drip time should be prolonged to 2-3 hours.The patient had no fever,cough and asthma after treatment.Blood routine and other indicators returned to normal,and bacterial culture was negative.Conclusions Laboratorians participating in clinical anti-infection treatment,and providing reasonable advice for clinicians could improve clinical cure rate of complex multidrug-resistant bacteria infection.