甲型副伤寒89例临床表现和药敏分析.docVIP

甲型副伤寒89例临床表现和药敏分析 　　[摘要] 目的:通过对甲型副伤寒的临床特点及药敏分析,为临床诊断及合理选择抗生素提供参考。方法:对89例甲型副伤寒沙门菌血液及骨髓培养阳性患者的临床表现及药敏及临床疗效进行统计学分析。结果:89例患者均有发热,血白细胞正常或减少,嗜酸粒细胞减少,50%有转氨酶升高、对多种抗生素高度敏感,尤其喹诺酮类、氨基糖苷类、头孢三代(头孢他啶、头孢曲松、头孢噻肟)及氯霉素敏感率大于90%,其中,左氧氟沙星、阿米卡星、庆大霉素、头孢他啶敏感率为100%,平均疗程10 d,平均退热时间5.4 d。结论:甲型副伤寒以发热为主,对多种药物敏感,考虑药物副作用、疗效、费用等因素,建议首选喹诺酮类,次选头孢类,合并肺部感染者可二者联用。 　　[关键词] 甲型副伤寒;临床表现;药敏试验;临床疗效 　　[中图分类号] R378.2+4[文献标识码]A [文章编号]1673-7210(2009)08(a)-036-02 　　 　　Analysis of clinical features and drug sensitivity of 89 cases of paratyphoid A LI Wenquan, KANG Tao 　　(Department of Infectious Disease, the Second Peoples Hospital of Yibin City, Yibin 644000, China) 　　[Abstract] Objective: To offer a guidance for clinical diagnosis and reasonable application of antibiotics by summarizing clinical presentations and drug sensitivity of paratyphoid A. Methods: Clinical features, laboratory characteristics and therapeutic efficacy of 89 cases with paratyphoid A were admitted in this clinical analysis. Results: The clinical manifestations of paratyphoid A included: fever, normal or count decline of white blood cell and blood eosinophilic granulocyte, half of the patients had rising aminotransferase and were sensitive to diverse antibiotics, especially to fluoquinolones, aminoglycoside, the third generation of cephalosporins (Ceftazidime, Cefotaxim) and Chloromycetin, the sensitive rates of them were higher than 90%, among them, the sensitive rates of Lavo-Ofloxacin, Butikacin, Gentamicin and Ceftazidime were 100%. Average course of treatment and defervesce was 10 and 5.4 days respectively. Conclusion: Patients with paratyphoid A show fever, sensitive to diverse antibiotics. Considering drug side-effect, healing effect and cost, fluoroquinolones is first choice and cephalo-type is second choice, both of them can combine when complicated with pneumonia. 　　[Key words] Paratyphoid fever A; Clinical feature; Drug sensitive test; Clinical efficacy 　　 　　近10年来我市伤寒发病明显减少,而甲型副伤寒发病率增加,就我院2005年5月～2006年6月收治的经血液、骨髓培养确诊的