头孢吡肟对产ESBL大肠埃希菌所致泌尿道感染的临床疗效观察

发布时间：2018-05-20 08:37

本文选题：头孢吡肟 + 超广谱β-内酰胺酶　；参考：《中国抗生素杂志》2012年12期

【摘要】：目的了解头孢吡肟治疗泌尿道感染的疗效以及针对大肠杆菌所致泌尿道感染的疗效,探讨头孢吡肟对产ESBL大肠杆菌泌尿道感染的临床使用及其疗效。方法收集临床诊断之泌尿道感染病人,使用头孢吡肟2.0 ivgtt q12h治疗,疗程7~14d;对临床分离的大肠埃希菌按照CLSI标准用纸片扩散法进行确证实验了解产超广谱β-内酰胺酶情况,并测定其MIC值。分析其所致感染用头孢吡肟治疗的临床疗效。结果共纳入泌尿系感染病人168例,疗程结束痊愈率70.83%,有效率85.12%。临床共分离大肠埃希菌81株,其中产超广谱β-内酰胺酶22株。体外对头孢吡肟的敏感率77.27%(17/22),临床治疗有效率81.82%(18/22),体外药敏与临床疗效具有一致性。结论头孢吡肟治疗泌尿道感染临床疗效好。针对体外敏感的产ESBL大肠埃希菌感染也存在确实疗效,是除碳青霉烯和头孢菌素/酶抑制剂外的另一选择。
[Abstract]:Objective to investigate the efficacy of cefepime in the treatment of urinary tract infection caused by Escherichia coli and to explore the clinical application and efficacy of cefepime in the treatment of urinary tract infection of ESBL-producing Escherichia coli. Methods the patients with urinary tract infection were collected and treated with cefepime 2.0 ivgtt q12h for 714d. The clinical isolated Escherichia coli was confirmed by disc diffusion according to CLSI standard to investigate the production of extended-spectrum 尾 -lactamases. The MIC value was determined. To analyze the clinical efficacy of cefepime in the treatment of infection caused by cefepime. Results 168 cases of urinary tract infection were included. The cure rate was 70.83% and the effective rate was 85.12%. A total of 81 strains of Escherichia coli were isolated, of which 22 strains produced extended-spectrum 尾-lactamases. The sensitivity of cefepime to cefepime in vitro was 77.27 / 22, and the effective rate of clinical treatment was 81.82 / 22. The drug sensitivity in vitro was consistent with the clinical efficacy. Conclusion Cefepime is effective in the treatment of urinary tract infection. In addition to carbapenem and cephalosporin / enzyme inhibitors, there is a definite effect on the infection of ESBL producing Escherichia coli in vitro, and it is an alternative to carbapenem and cephalosporin / enzyme inhibitors.
【作者单位】：四川大学华西医院感染性疾病中心;
【分类号】：R446.5

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