伤寒的临床特点与耐药性研究

Investigation of clinical characteristics and drug sensitivity of salmonella typhi

目的 探讨近年伤寒的临床特点和常用抗菌药物的耐药性及疗效。方法 收集经血培养和(或 )骨髓培养确诊的伤寒住院病人 97例 ,分析其临床特征、药敏试验和治疗效果。结果 本组伤寒的临床特征是热程长 (平均为 2 5 6d) ,病情重 ,并发症多。稽留热仍较多见 (5 5 7% ) ,脾肿大是主要体征。肥达反应阳性率为 6 7 1%。药敏试验呈多重耐药性 ,抗菌药物以喹诺酮类和三代头孢菌素疗效显著 ,其他药物单用效果普遍不佳。结论 多重耐药性的伤寒临床症状重 ,对常用治疗药物耐药性大 ,抗菌治疗应以氟啶酸或氟嗪酸等喹诺酮类为首选 ,联合用药效果更佳。

Objective In order to investigate the clinical features of typhoid,and the relationship between the common drugs resistant salmonella typhi and therapeutic efficacy with those drugs for typhoid.Methods Subjects studied were 97 cases from whom salmonella typhi strains were found using blood or bone marrow cultivation.We investigated the clinical manifestations,drug sensitivity and the therapeutic efficacy for the patients.Results The clinical features in the patients were long-term fever(25.6d),servere general condition and more complications.Sustained fever was most common(55.6%).Spleen tumefaction was the main sign,the positive rate of Widal reaction was 67.1%.Drug sensitivity tests displayed the bacteria resist more than two of the common drugs,but more sensitive to quinolone and third generation cephalosporin antibiotics.Conclusion Multiple-drug resistance salmonella typhi resistant to the common drugs for typhoid,but more sensitive to quinolone.Enoxasin and ofloxacin are first choice for treatment.Combined two kinds of drugs for typhoid has the best curative effect.