临床常见耐药菌的治疗策略.pdfVIP

Drugs and Clinic 药物与临床 临床常见耐药菌的治疗策略 1 2 1* 赵捷 ，于丽婧 ，王佳庆 1.首都医科大学附属北京天坛医院药剂科，北京 100050；2.北华大学药学院临床药学系，吉林 吉林 132013 [摘要] 近年来，随着抗生素和免疫抑制剂的广泛使用，耐药菌株已经成为引起临床感染最为常见的病原菌。特别是医院内部 耐药菌株的感染，使得病死率大幅度的增加，一些综合性的大医院的医院感染发病率可能会更高，其治疗方法已经成为临床 上面临的巨大难题。因此，对耐药菌株的治疗就显得尤为迫切。所以，本文对临床上一些常见的耐药细菌以及其治疗手段进 行了总结，希望能够对临床应用提供一些帮助。 [关键词] 耐药细菌；治疗药物；耐药机制 [中图分类号] R978.1 [文献标识码] A [文章编号]1672-2809(2014)10-0019-04 Treatment Strategy of Common Resistant Bacteria Infection 1 2 1* ZHAO Jie , YU Li-jing, WANG Jia-qing 1. Department of Pharmacy, Beijing Tiantan Hospital Affiliated to Capital Medical University, Beijing 100050, China; 2. Department of Clinical Pharmacy, School of Pharmaceutical Sciences, Beihua University, Jilin 132013, China [Abstract] In recent years, with the wide use of antibiotics and immunosuppressants, drug resistant strains have become the most common pathogen of clinical infection. Resistance of strains in hospital acquired infection make the mortality increased significantly. The rate could be higher in some large comprehensive hospital. Treatment of resistant bacteria has become a big problem. Therefore, the treatment of drug resistant strains is particularly urgent. In this paper, some of the common clinical drug resistant bacteria and its treatment were induced, hoping to provide some help for clinical applications. [Key words] Drug-resistant; Treatment Strategy; Resistance Mechanisms 细菌的耐药性一般是指致病细菌多次反复的 1.1.1耐甲氧西林葡萄球菌(MRS) 耐甲氧西林葡萄球 接触治疗药物后，使细菌对该药的敏感性 菌(MRS)分为耐甲氧西林金黄色葡萄球菌(MRSA)、 [1] 下降甚至消失 。若为了达到与以前相同的效果，就 耐甲氧西林表皮葡萄球菌(MRSE)、耐甲氧西林溶 [2] 需要增加药物的使用剂量或者增加药物的使用频率， 血葡萄球菌(MRSH) 。它们的传播途径可分为直接 长此以往，就使得该