产超广谱β-内酰胺酶细菌感染患者治疗与预后的相关性研究

Relationship between Treatment and Prognosis in Infected Patients with ESBLs -producing Bacteria

目的 探讨产超广谱 β 内酰胺酶 (ESBLs)细菌感染患者的治疗与预后的相关性。方法 应用MicroScan微生物自动鉴定系统进行细菌鉴定与药敏试验 ,筛选出多重耐药菌株 ,并应用双纸片扩散法进行ESBLs检测 ,追踪患者预后。结果 多重耐药菌株中ESBLs的阳性率为 5 1.9% ,82株ESBLs阳性菌株中总死亡率为 19.5 1% ,用亚胺培南 (IMP)或酶抑制剂治疗者治愈率 (4 6 .5 1% )明显高于未用IMP或酶抑制剂治疗者 (2 3.0 8% ) ;死亡率 (6 .98% )明显低于未用IMP或酶抑制剂治疗者 (33.33% ) ,两者比较差异均有显著性。结论 对产ESBLs多重耐药菌株感染患者及时进行治疗可提高患者治愈率 ,降低患者死亡率。

OBJECTIVE To study the relationship between the treatment and prognosis in infected patients with extended spectrum β lactamases ( ESBLs ) producing bacteria. METHODS Multi resistant bacteria were selected by the MicroScan system and susceptibility test, and detected the ESBLs by double disc diffusion method among 158 multi resistant Gram negative bacilli which were isolated from clinical samples, the prognosis was then pursuited. RESULTS The positive rate of ESBLs among multi resistant bacilli was 51.9%(82/158),the total death rate due to 82 ESBLs producing bacteria was 19.51%.In the patients with ESBLs producing bacteria,the death rates of using imipenem(IMP)/β lactamase inhibitors and not using of that were 6.98% and 33.33%, respectively.The recovery rates of using IMP/β lactamase inhibitors and not using of that were 46.51% and 23 08%,respectively. There was significantly difference, P<0.005. CONCLUSIONS It was important to detect the ESBLs , especially to multi resistant bacteria, it can direct the use of clinical antibiotics, and decrease the death rate and increase the recovery rate of patients.