革兰阴性菌血流感染患者的细菌耐药情况及疗效比较

Comparison of bacterial drug resistance and therapeutic effect in patients with gram-negative bacterial bloodstream infection

目的分析革兰阴性菌血流感染患者的细菌耐药情况、临床症状及实验室指标等,比较头孢哌酮钠舒巴坦钠与亚胺培南西司他汀治疗革兰阴性菌血流感染的临床效果,为临床早期经验性治疗提供依据。方法回顾性分析2018年1月—2020年6月漳州市第三医院收治的革兰阴性杆菌血流感染患者121例的临床资料,其中包括头孢哌酮钠舒巴坦钠组(80例)和亚胺培南西司他汀组(41例),统计2组相关数据并比较。结果121例革兰阴性杆菌血流感染患者中大肠埃希菌80株,克雷伯菌属26株,变形杆菌4株,铜绿假单胞菌3株,阴沟肠杆菌4株,黏质沙雷菌2株,鲍曼不动杆菌1株,沙门菌1株,产ESBLs的菌株36株(29.75%,36/121)。头孢哌酮钠舒巴坦钠与亚胺培南西司他汀治疗革兰阴性杆菌血流感染3 d后的PCT下降程度、抗菌药物使用天数、体温控制天数、住院天数、治疗效果及28 d后的病死率均无明显差异。头孢哌酮钠舒巴坦钠与亚胺培南西司他汀治疗革兰阴性菌血流感染的疗效及病死率未见明显差异。结论头孢哌酮钠舒巴坦钠与亚胺培南西司他汀治疗革兰阴性菌血流感染疗效及病死率未见明显差异。

Objective The bacterial drug resistance,clinical symptoms and laboratory indexes of patients with gramnegative bacterial bloodstream infection were analyzed.To compare the efficacy of cefoperazone/sulbactam sodium and imipenem cilastatin in the treatment of gram-negative bacterial bloodstream infection,so as to provide basis for early clinical empirical treatment.Methods The clinical data of 121 patients with gram-negative bacilli bloodstream infection treated in Zhangzhou Third Hospital from January 2018 to June 2020 were analyzed retrospectively.These included cefoperazone/sulbactam sodium group(80 cases)and imipenem cilastatin group(41 cases).The two groups of relevant data were counted and compared.Results Among 121 patients with gram-negative bacilli bloodstream infection,80 strains of Escherichia coli,26 strains of Klebsiella,4 strains of Bacillus proteus,3 strains of Pseudomonas aeruginosa,4 strains of Enterobacter cloacae,2 strains of Serratia marcescens,1 strain of Acinetobacter baumannii,1 strain of Salmonella and 36 strains of ESBLs producing strains(29.75%,36/121).There was no significant difference between cefoperazone/sulbactam sodium and imipenem cilastatin in the degree of PCT decline,the number of days of use of antibiotics,the number of days of temperature control,the number of days of hospitalization,the treatment effect and the mortality after 28 days.There was no significant difference in the efficacy and mortality of cefoperazone/sulbactam sodium and imipenem cilastatin in the treatment of gram-negative bacterial bloodstream infection.Conclusion There was no significant difference in the efficacy and mortality of cefoperazone/sulbactam sodium and imipenem cilastatin in the treatment of gram-negative bacterial bloodstream infection.