美罗培南与头孢哌酮-舒巴坦治疗儿科产 ESBLs 菌致支气管肺炎的临床疗效及安全性评价

目的：评价美罗培南与头孢哌酮-舒巴坦治疗儿科产超广谱β-内酰胺酶（ESBLs）耐药菌致支气管肺炎的临床疗效及安全性。方法：入选186例患儿病例，按用药情况分为美罗培南组与头孢哌酮-舒巴坦组，进行回顾性统计研究。采用 spss 22.0统计软件进行数据处理，用 t 检验或χ2检验，比较两组间的基本资料齐同性，统计菌群分布及耐药率，分别计算细菌清除率、治疗有效率及抗菌药物费用。结果：两组病例中共分离细菌186株，主要产 ESBLs 菌为大肠埃希菌（56.99%）和肺炎克雷伯菌（37.63%）。美罗培南组与头孢哌酮-舒巴坦组治疗儿科产ESBLs 菌致支气管肺炎的细菌清除率分别为86.95%及57.44%，总有效率分别为82.60%和87.23%。日平均费用美罗培南组是头孢哌酮-舒巴坦组的7.5倍。结论：美罗培南与头孢哌酮-舒巴坦治疗产 ESBLs 菌致支气管肺炎疗效确切，不良反应发生率低。对产 ESBLs 菌致患儿支气管肺炎首选美罗培南，头孢哌酮-舒巴坦可作为降阶治疗的备选药物。

The Therapeutic Effect and safety of Meropenem and cefoperazone/sulbactam On ESBLs causing Bronchopneumonia in Pediatrics

Objective To evaluate the efficacy and safety of meropenem and cefoperazone/sulbactam on producing Ex-tended Spectrum Beta-Lactamases (ESBLs) bacterias causing bronchopneumonia in pediatrics. Methods 186 patients were enrolled according to inclusive criteria, and divided into meropenem and cefoperazone/sulbactam group. Retrospective statisti-cal studies was carried on and spss22.0 was used to make t test and x2 test between two groups. Comparison between the two groups of the basic information of his gay, and statistics and flora distribution, and resistance to bacterial clearance rate. Cost efficient and antimicrobial treatment were calculated respectively. Results The 186 strains bacteria were isolated, and the main producing ESBLs bacteria were e. coli bacteria (56.99%) and klebsiella pneumonia (37.63%). The rate of bacterial eradication in these two groups were 86.95% and 57.44%, total effective rates were 82.60 % and 87.23%. The average daily cost in mero-penem treatment group was 7.59 times compared with cefoperazone/sulbactam group. Conclusion The meropenem and cefop-erazone/sulbactam against the bronchopneumonia caused by producing ESBLs bacterias had definite therapeutic effect and low incidence of adverse reactions. Althouth the efficacy of meropenem was better than cefoperazone/sulbactam, the latter could be the alternative at some cases.