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目的 探讨近年伤寒的临床特点和常用抗菌药物的耐药性及疗效。方法 收集经血培养和(或 )骨髓培养确诊的伤寒住院病人 97例 ,分析其临床特征、药敏试验和治疗效果。结果 本组伤寒的临床特征是热程长 (平均为 2 5 6d) ,病情重 ,并发症多。稽留热仍较多见 (5 5 7% ) ,脾肿大是主要体征。肥达反应阳性率为 6 7 1%。药敏试验呈多重耐药性 ,抗菌药物以喹诺酮类和三代头孢菌素疗效显著 ,其他药物单用效果普遍不佳。结论 多重耐药性的伤寒临床症状重 ,对常用治疗药物耐药性大 ,抗菌治疗应以氟啶酸或氟嗪酸等喹诺酮类为首选 ,联合用药效果更佳。
Objective To investigate the clinical features of typhoid fever in recent years and the commonly used antimicrobial resistance and efficacy. Methods Ninety-nine inpatients with typhoid fever confirmed by menstrual blood culture and / or bone marrow culture were collected, and their clinical characteristics, drug susceptibility tests and therapeutic effects were analyzed. Results The clinical features of typhoid fever in this group is long (average 2,556 days), severe illness and more complications. Retention heat is still more common (57.5%), splenomegaly is the main sign. Widal response positive rate of 6 7 1%. Drug susceptibility tests showed multiple drug resistance, quinolones and third-generation cephalosporins antibacterial significant effect, other drugs alone generally poor results. Conclusions The clinical symptoms of multiple drug-resistant typhoid fever are heavy and resistant to common therapeutic drugs. Antifungal therapy should be given quinolones such as fiuidic acid or flufenamic acid, and the combination effect is better.