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文章编号:1009—4237(2010)04-0306一04
广谱抗生素对肠道菌群紊乱诱导的侵袭性
真菌感染的影响
王虑,刘绍泽,王胜云,李文放,陈德昌
【摘要】
目的探讨广谱抗生素对肠道菌群紊乱诱导的侵袭性真菌感染(In)的影响。方法
回顾性
收集ICU院内获得性感染92例,根据细菌检测结果分别采用二代头孢菌素、酶抑制剂、碳青霉烯类抗生素
治疗,于抗生素治疗前和治疗后3、7天进行细菌学检测,治疗前和治疗后3、7天和14天行大便球杆菌比例
和念珠菌的检测。结果应用广谱抗生素治疗后患者肠道球杆菌比例增高,并随应用时间的延长,球杆菌
比例呈进行性升高,治疗后7天与治疗后3天比较有显著性差异(P<);并在粪便内检出白色念珠
菌、光滑念珠菌、热带念珠菌等。酶抑制剂和碳青霉烯组在治疗7天后即可出现In,14天后IFI发生率增
加,且维持原方案治疗者肠道菌群紊乱加重(P<),真菌感染发生率高于降阶梯治疗者。结论广谱
抗生素的应用造成肠道菌群紊乱,IFl发生率增高,需合理调整抗生素方案以控制IFI的发生率。
【关键词】抗生素;肠道;细菌;念珠菌
【中图分类号】
【文献标识码】A
Effect of antibiotics
on
invasive fungal infection induced
by intestinal flora disturbance
WANG Lv。LIU Shao-ze,WANG
Sheng—yun。ⅡWen-fang。CHEN De—chang
(Department
of Emergeney。Changzheng Hospital-Second Military Medical University-Shanghai
200003-China)
【Abstract】
Objective
To
study the effect of broad・spectrum antibiotics
invasive fungal infection in-
duced by
intestinal flora
y-two patients with ial infection
collected and
retrospectively generation cephalosporin-enzyme inhibitor and
earbapenem
respectively
used
according
the bacteria
results of
bacteria
conducted
before bacteria treatment and
the 3rd day,7th day after the
US-bacillus ratio and eandida
were conducted
before and
the 3rd day,7th day and 1