郑盼盼;陈锡创;洪远;陈艳华;韩美玲;王燕;

• 1:浙江省宁波市第六医院药剂科
• 2:江苏省无锡市第九人民医院ˉ苏州大学附属无锡九院药学部
• 3:南京医科大学附属无锡儿童医院药学部

摘要(Abstract)：

目的探讨支气管扩张症伴施氏假单胞菌感染的抗感染治疗的特点及开展药学监护的必要性。方法以临床药师参与1例痰培养示施氏假单胞菌阳性的支气管扩张患者的抗感染治疗经过为例,结合相关文献及患者疾病特点,阐述治疗各阶段抗感染药物的合理性和药学监护要点。结果该患者在入院后予头孢他啶抗感染治疗4 d后感染症状未得到有效控制,在临床药师推荐下改用哌拉西林钠他唑巴坦联合阿奇霉素的抗感染治疗方案后,细菌得到清除,患者痊愈出院。治疗期间,临床药师对抗感染药物的不良反应进行了监护,及时发现和解决了患者用药期间出现的腹泻、腹痛等不良反应。结论支气管扩张伴施氏假单胞菌感染治疗时需考虑耐药性,选择合适的抗感染药物足疗程治疗至关重要;在治疗过程中监护药物不良反应,在保障安全用药方面起着一定的积极作用。

关键词(KeyWords)： 施氏假单胞菌;支气管扩张症;抗感染治疗;临床药师

Abstract:

Keywords:

基金项目(Foundation): 无锡市卫健委中青年拔尖人才资助计划（编号BJ2020087、HB2020115）

作者(Author): 郑盼盼;陈锡创;洪远;陈艳华;韩美玲;王燕;

Email:

DOI: 10.19577/j.1007-4406.2021.01.014

参考文献(References)：

• [1]HILL A T,SULLIVAN A L,CHALMERS J D,et al.British Thoracic Society Guideline for bronchiectasis in adults[J].Thorax,2019,74(Suppl 1):1.
• [2]成人支气管扩张症诊治专家共识编写组.成人支气管扩张症诊治专家共识[J].中华结核和呼吸杂志,2012,35(7):485.
• [3]BASHAR S,SANYAL S K,SULTANA M,et al.Emergence of IntI1 associated blaVIM-2 gene cassette-mediated carbapenem resistance in opportunistic pathogen Pseudomonas stutzeri[J].Emerg Microbes Infect,2017,6(5):e29.
• [4]BISHARAT N,GORLACHEV T,KENESS Y.10-years hospital experience in Pseudomonas stutzeri and literature review[J].Open Infect Dis J,2012,6(1):21.
• [5]SHAH A,SENGER D,GARG B,et al.Post cataract Pseudomonas stutzeri endophthalmitis:report of a case and review of literature[J].Indian J Ophthalmol,2020,68(1):232.
• [6]HALABI Z,MOCADIE M,EL ZEIN S,et al.Pseudomonas stutzeri prosthetic valve endocarditis:a case report and review of the literature[J].J Infect Public Health,2019,12(3):434.
• [7]MOLGATINI S,REY E,BASILAKI J.Isolation of Pseudomonas stutzeri from an odontogenic infl ammatory cyst Diagnostic relevance.[J].Revista Argentina De Microbiologia,2017,49(1):32.
• [8]SHALABI A,EHRLICH T,SCHERS H J,et al.Infective endocarditis caused by Pseudomonas stutzeri in a patient with Marfan syndrome:case report and brief literature review[J].IDCases,2017,10:22.
• [9]MIRON D,KENESS Y,BOR N,et al.Pseudomonas stutzeri knee arthritis in a child:case report and review[J].J Pediatr Orthop Part B,2007,16(6):419.
• [10]POLVERINO E,GOEMINNE P C,MCDONNELL M J,et al.European Respiratory Society guidelines for the management of adult bronchiectasis[J].Eur Respir J,2017,50(3).DOI:10.1183/13993003.00629-2017.
• [11]CERI M,ORTABOZKOYUN L,ALTAY M,et al.Peritonitis due to Pseudomonas stutzeri,an organism that may be difficult to culture[J].Perit Dial Int,2010,30(4):484.
• [12]LIN K H,CHEN C M,WANG J H,et al.Pseudomonas stutzeri necrotizing pneumonia in pre-existing pulmonary tuberculosis[J].Internal Medicine,2014,53(21):2543.
• [13]明德松,潘艳萍.施氏假单胞菌的临床分布及其耐药性研究[J].中国药房,2013,24(14):1276.
• [14]CLSI.Performance Standards for Antimicrobial Susceptibility Testing.30th ed.CLSI supplement M100.Wayne,PA:Clinical and Laboratory Standards Institute,2020:221.
• [15]SHI W,LI K,JI Y,et al.Carbapenem and cefoxitin resistance of Klebsiella pneumoniae strains associated with porin OmpK36 loss and DHA-1β-lactamase production[J].Braz J Microbiol,2013,44(2):435.
• [16]AGUILERA ROSSI C G,GóMEZ-PUERTAS P,AYALASERRANO J A.In vivo functional and molecular characterization of the Penicillin-Binding Protein 4 (DacB) of Pseudomonas aeruginosa[J].BMC Microbiol,2016,16(1):234.
• [17]闫宁,杨智敏,尚立国,等.非生物胁迫条件下施氏假单胞菌生物膜形成规律的研究[J].生物技术通报,2017(2):172.
• [18]中华医学会呼吸病学分会感染学组.铜绿假单胞菌下呼吸道感染诊治专家共识[J].中华结核和呼吸杂志,2014,37(1):9.
• [19]CARVALHO-ASSEF A P D,GOMES M Z R,SILVA A R A,et al.IMP-16 in Pseudomonas putida and Pseudomonas stutzeri:potential reservoirs of multidrug resistance[J].J Med Microbiol,2010,59(9):1130.