某院重症监护病房接受静脉-静脉血液滤过治疗且使用万古霉素患者病原学情况调查

摘要

目的：筛选某院ICU接受静脉-静脉血液滤过（CVVH）治疗且使用万古霉素的患者，对其病原学情况进行调查，以期为临床用药提供参考。方法筛选出接受CVVH治疗且使用万古霉素的80例患者，对其病原学情况进行分析。结果屎肠球菌16例，测得万古霉素的最低抑菌浓度（MIC）值小于2.0 mg/L。耐甲氧西林金黄色葡萄球菌（MRSA）、耐甲氧西林表皮葡萄球菌（MRSE）、耐苯唑西林的凝固酶阴性葡萄球菌（MRSCON）分别检出4例，测得万古霉素的MIC值小于1.0 mg/L，其他革兰阳性球菌均对万古霉素敏感。结论MIC值≥1.0 mg/L，或检出屎肠球菌、MRSA、MRCNS、MRSE等耐药菌的，建议万古霉素血药谷浓度控制在15～20 mg/L。MIC值＜1.0 mg/L，或检出其他革兰阳性菌的，建议万古霉素血药谷浓度控制在10～15 mg/L。%Objective In this paper, we select patients who received CVVH and vancomycin treatment in ICU of a hospital, investigate its etiology, in order to provide reference for clinical medication.Methods 80 patients who received CVVH and vancomycin treatment were chosen. The pathogenic data were selected and analyzed.Results EF were detected in 16 cases. MIC value were less than 2 mg/L. MRSA, MRSCON, MRSE were detected in 4 cases, respectively. MIC value were less than 1 mg/L. Other gram positive bacteria were sensitive to vancomycin.Conclusion MIC≥1.0 mg/L, or EF, MRSA and MRCNS, MRSE and other resistant bacteria were detected, trough concentration should be controlled in 15~20 mg/L. MIC< 1.0 mg/L, or other gram positive bacteria were detected, trough concentration should be controlled in 10~15 mg/L.