美罗培南治疗新生儿重症多重耐药菌感染的有效性

Effectiveness of Meropenem in the Treatment of Severe Neonatal Multi-drug Resistant Infections

目的探讨美罗培南治疗新生儿重症多重耐药菌感染的临床效果。方法2016年3月—2019年3月该院收治的110例重症多重耐药菌感染新生儿作为研究对象,利用随机数字表法均分为研究组(55例,美罗培南治疗)和对照组(55例,头孢他啶治疗),比较两组患儿的治疗效果、不良反应发生情况和生化指标改善情况。结果110例重症多重耐药菌感染新生儿经过细菌学检验均为阳性,其中革兰阴性菌的例数为60(54.55%),革兰阳性菌的例数为32(29.09%),真菌例数为18(16.36%);研究组的临床治疗有效率(90.91%)优于对照组的临床治疗有效率(74.55%),差异有统计学意义(χ^2=5.153,P<0.05);研究组的不良反应发生率(10.91%)低于对照组的不良反应发生率(32.73%),差异有统计学意义(χ^2=7.674,P<0.05);治疗前研究组的血清C-反应蛋白(CRP)以及降钙素原(PCT)分别为(24.19±3.11)mg/L、(2.44±3.66)ng/mL,对照组的CRP、PCT分别为(23.88±3.14)mg/L、(2.46±3.51)ng/mL,治疗前两组患者的CRP、PCT比较差异无统计学意义(P>0.05),治疗后研究组的CRP和PCT分别为(7.95±4.11)mg/L、(0.34±0.11)ng/mL,对照组的CRP和PCT分别为(12.99±3.77)mg/L、(0.69±0.24)ng/mL,治疗后研究组的CRP、PCT改善程度均优于对照组,差异有统计学意义(P<0.05)。结论对多重耐药菌感染新生儿给予美罗培南治疗,可以有效提高临床治疗效果,改善患儿的生化指标,不良反应少,具有良好的安全性。

Objective To investigate the clinical effect of meropenem in the treatment of neonatal severe multi-drug resistant bacteria infection.Methods 110 cases of severely infected newborns with multi-drug resistant bacteria who came to the hospital from March 2016 to March 2019 were selected as the research objects,and they were equally divided into the study group(55 cases,meropenem treatment)and the control group(55 cases,Ceftazidime treatment),and then compare the treatment effects,adverse reactions and improvement of biochemical indicators between the two groups of children.Results 110 cases of severely infected neonates with multi-drug resistant bacteria were all positive after bacteriological examination.Among them,the number of gram-negative bacteria was 60(54.55%)and the number of gram-positive bacteria was 32(29.09%).The number of fungal cases was 18(16.36%);the effective rate of clinical treatment in the study group(90.91%)was better than that in the control group(74.55%),the difference was stitastically significant(χ^2=5.153,P<0.05);The incidence of adverse reactions in the group(10.91%)was lower than the incidence of adverse reactions in the control group(32.73%),the different was statistically significant(χ^2=7.674,P<0.05);the serum C-reactive protein(CRP)of the study group before treatment and procalcitonin(PCT)were(24.19±3.11)mg/L,(2.44±3.66)ng/mL,and the CRP and PCT of the control group were(23.88±3.14)mg/L,(2.46±3.51)ng/mL,there was no statistically significant difference in CRP and PCT between the two groups before treatment(P>0.05).After treatment,the CRP and PCT of the study group were(7.95±4.11)mg/L and(0.34±0.11)ng/mL,respectively.The CRP and PCT of the control group were(12.99±3.77)mg/L and(0.69±0.24)ng/mL,respectively.After treatment,the improvement of CRP and PCT of the study group were better than those of the control group,the difference was statistically significant(P<0.05).Conclusion Treating neonates with symptomatic multi-drug resistant bacteria infection with meropenem can effectively improve the clinical treatment effect and improve the biochemical indicators of the children,with few adverse reactions and good safety.