摘要
目的探讨副伤寒甲临床表现及耐药情况,为其有效预防和合理治疗提供参考依据。方法回顾性分析2015年1月至2016年1月收治的24例副伤寒甲流行病学资料、临床表现、诊断、药物敏感试验、治疗及转归,分析耐药性特征。结果近期副伤寒甲临床表现不典型,急性高热占95.83%,肌肉酸痛占87.50%,腹痛、腹泻占20.83%,恶心呕吐占16.67%,无表情淡漠、皮肤玫瑰疹、相对缓脉等。白细胞计数(5.078±1.480)×109/L,嗜酸性粒细胞计数为(0.003±0.007)×109/L;降钙素原小于或等于0.5ng/mL占58.33%;超敏C反应蛋白(96.89±80.17)mg/L,脾大占20.8%,肝大占4.17%。耐药率前5位由高到低为氨曲南(62.50%),哌拉西林/他唑巴坦(50.00%),氨苄西林(29.20%),阿莫西林/克拉维酸(12.50%),哌拉西林(12.50%)。敏感率由高到低为碳青霉烯类(100.00%),替卡西林/克拉维酸(100.00%),三代头孢菌素(95.83%),左氧氟沙星(95.83%),复方新诺明(95.83%)。结论副伤寒甲临床表现不典型,氨曲南、哌拉西林/他唑巴坦、氨苄西林耐药率高;左氧氟沙星或(和)头孢曲松耐药率低,疗效确切。
Objective To analyze the clinical manifestations and drug resistance of paratyphoid fever A in 2015,and to provide reference for the effective prevention and reasonable treatmen. Methods A retrospective analysis of clinical manifestations and drug resistance of pathogenic bacteria in blood and stool culture from Janucary 2015 to January 2016 were carried out,including epidemiological data,clinical features,diagnosis,drug sensitivity test, treatment and outcomes. Results Recent paratyphoid A clinical manifestation were not typical,acute fervescence（95.83%）, myosalgia （87. 50%）, abdominal pain and diarrhea（20.83%）, nausea and vomiting （16.67% ）, no malaise, skin roseola, relative bradycardia. White blood cell count （5. 078 ± 1. 480） × 10^9/L in all of cases. Eosinophils count （0. 003 ± 0. 007） ×10^9/L. PCT〈0. 5 ng/mL, accounting for 58. 33%; high sensitivity C reactive protein： （96.89±80. 17）mg/L. The resistance rate of the top five from high to low： aztreonam （62. 50%）, piperacillin tazobactam （50.00%） ,ampicillin （29.20%）, amoxicillin and clavulanate potassium, piperacillin, piperacillin （12. 50% ）. Sensitive rates were from high to low： carbapenems and Ticarcitlin Disodium and Clavulanate Potassium （100. 00%）, third-generation cephalosporin （95.83%） ,Levofloxacin （95.83%） ,SMZ-TMP （95.83%）. Conclusion The clinical manifestation of paratyphoid A was not typical,the resistant rate of aztreonam, piperacillin-tazobactam and ampicillin was higher; the resistant rate of levofloxacin or （and） ceftriaxone was lower,curative effect.
出处
《重庆医学》
CAS
北大核心
2016年第22期3083-3085,共3页
Chongqing medicine
