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目的:探讨哌拉西林/他唑巴坦对减少产超广谱β-内酰胺酶(ESBL)大肠埃希菌或肺炎克雷伯菌定植的价值。方法:研究分为3个月的第Ⅰ阶段(干预前阶段)和6个月的第Ⅱ阶段(干预阶段),在干预前阶段,所有患者均按常规应用抗菌药物治疗各种感染。第Ⅱ阶段前3个月开始抗菌药物干预,所有感染患者推荐用哌拉西林/他唑巴坦治疗(替代3代头孢至少50.0%)。通过直肠拭子培养检查,用双纸片扩散法测定干预前阶段和干预后阶段(最后3个月)患者是否产ESBL的大肠埃希菌或肺炎克雷伯菌。结果:(1)总体上产ESBL的大肠埃希菌或肺炎克雷伯菌的获得率在干预前后从20.0%降至17.0%,但差异无统计学意义。(2)在社区产ESBL的大肠埃希菌或肺炎克雷伯菌呈高的获得率。结论:医院内干预前后产ESBL大肠埃希菌或肺炎克雷伯菌的获得率差异无统计学意义。
Objective: To evaluate the value of piperacillin / tazobactam in reducing ESBL-producing Escherichia coli or Klebsiella pneumoniae colonization. Methods: The study was divided into 3 months of stage I (pre-intervention stage) and 6 months of stage II (intervention stage), in which all patients were routinely treated with antimicrobial agents for various infections. Antimicrobial intervention was started in the first 3 months of stage II, and piperacillin / tazobactam (at least 50.0% instead of 3rd generation cephalosporins) was recommended for all infected patients. Examination of rectal swab cultures was performed to determine whether ESBL-producing Escherichia coli or Klebsiella pneumoniae were present in the pre- and post-interventional phases (last 3 months) by double disk diffusion. Results: (1) The overall yield of ESBL-producing Escherichia coli or Klebsiella pneumoniae decreased from 20.0% to 17.0% before and after intervention, but the difference was not statistically significant. (2) High availability of ESBL-producing Escherichia coli or Klebsiella pneumoniae in the community. Conclusion: There was no significant difference in the yield of ESBL-producing Escherichia coli or Klebsiella pneumoniae before and after hospital intervention.