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        细菌学年毕业论文 细菌药敏临床药效不符的常见原因

        版权:原创标记本站原创 星级:★★★★★3.0主题:大肠杆菌范文 级别:精品毕业论文 范畴:研究生学年论文 论文范文编号:biyelunwendq0239734 期刊发表:论文发表 全文字数:5000字 投稿作者:njdrcz 审稿编辑:著名学术家 阅读次数:53929

        关于免费细菌论文范文在这里免费下载与阅读,为您的细菌相关论文写作提供资料。

        细菌药敏与临床药效不符的常见原因分析【摘要】微生物检测技术与临床规范化用药紧密联系。临床经验性用药以细菌药敏实验结果为依据;实验室药敏结果来源于体外实验,当药敏结果与临床药效出现较大差异时,有时甚至出现临床用敏感药无效, 而用不敏感药有效的情况。

        大肠杆菌论文 大肠杆菌

        空调不制冷常见原因处理措施

        关东军细菌部队背荫河平房基地择址原因刍议

        肉牛常见皮肤病的发病特点、临床症状防治措施

        肉牛食盐中毒发生原因、临床症状、剖检变化治疗

        【关键词】天然耐药、体外药敏试验、细菌产生耐药性

        1004-4949(2014)09-0557-01

        理由分析:

        1.常见致病菌的天然耐药

        1.1所有肠杆菌科:青霉素G,糖肽类,夫西地酸,大环内酯类,克林霉素,利奈唑胺;

        1.2不动杆菌:氨苄西林,阿莫西林,第一、二代头孢菌素、第一代喹诺酮类、克林霉素;

        1.3铜绿假单胞菌:氨苄西林,阿莫西林,阿莫西林/克拉维酸,第一代头孢菌素,第二代头孢菌素,头孢噻肟,头孢曲松,萘啶酸, 甲氧苄啶,复方新诺明。对多粘菌素天然敏感。

        1.4洋葱伯克霍德菌:氨苄西林,阿莫西林,第一代头孢菌素,多粘菌素, 氨基糖甙类;

        1.5食麦芽窄食单胞菌:除外替卡西林/克拉维酸的所有β-内酰胺类, 氨基糖甙类;

        1.6黄杆菌属(金黄杆菌属/芳香黄杆菌:氨苄西林,阿莫西林,第一代头孢菌素;

        1.7沙门菌属:头孢呋新(在体外试验可能显示活性,但体内没有活性);

        细菌药敏临床药效不符的常见原因硕士论文开题报告相关参考属性
        有关论文范文主题研究: 关于细菌论文范文集 大学生适用: 5000字专科论文
        相关参考文献下载数量: 44 写作解决问题: 写作参考
        毕业论文开题报告: 论文提纲、论文小结 职称论文适用: 论文发表、高级职称
        所属大学生专业类别: 大肠杆菌课题 论文题目推荐度: 最新细菌题目

        1.8克雷伯菌属,异型枸橼酸杆菌:氨苄西林,阿莫西林, 羧苄西林,替卡西林;

        1.9肠杆菌属,弗劳地枸橼酸杆菌:氨苄西林,阿莫西林,第一代头孢菌素,头孢西??;

        1.10摩根摩根菌:氨苄西林,阿莫西林,阿莫西林/克拉维酸,第一代头孢菌素,头孢呋新,多粘菌素E,呋喃妥因:

        1.11普罗威登菌属:氨苄西林,阿莫西林,阿莫西林/克拉维酸,第一代头孢菌素,头孢呋新,庆大霉素,奈替米星,妥布霉素,多粘菌素E;

        1.12奇异变形杆菌(奇异杆菌):多粘菌素E,呋喃妥因、四环素;

        1.13普通变形杆菌:氨苄西林,阿莫西林,头孢呋新,多粘菌素E,呋喃妥因;

        关于超级细菌

        中医临床医学论文临床医学专科毕业论文医学临床本科毕业论文临床医学论文怎么写临床医学本科毕业论文范文临床医学类论文

        1.14沙雷菌属:氨苄西林,阿莫西林,阿莫西林/克拉维酸,第一代头孢菌素,头孢呋新,多粘菌素E;

        1.15小肠结肠炎耶尔森菌:氨苄西林,阿莫西林, 羧苄西林,替卡西林,第一代头孢菌素;

        1.16空肠弯曲菌,大肠弯曲菌: 甲氧苄啶;

        1.17流感嗜血杆菌:青霉素G,红霉素,克林霉素;

        1.18卡他莫拉菌: 甲氧苄啶;

        1.19所有的革兰阳性菌:氨曲南, 替莫西林,多粘菌素E, 萘啶酸;

        1.20链球菌:夫西地酸, 氨基糖甙类(除做协同外)、氨区南、一代喹诺酮、多粘菌素; 天然敏感:万古、 青霉素G

        1.21肺炎链球菌: 甲氧苄啶,氨基糖苷类;

        1.22MRSA:所有的β-内酰胺类;

        1.23肠球菌:青霉素G, 羧苄西林,替卡西林,所有的头孢菌素类,氨基糖苷类, 莫匹罗星; 鹑鸡肠球和铅黄肠球对万古天然耐药。

        1.24葡萄球菌:对氨区南、萘4李斯特菌:第三代头孢菌素, 氟喹诺酮类.定算、多粘菌素天然耐药。

        2. 体外药敏试验和体内药物疗效确实有差异

        主要是因为体外和体内的环境不同, 有些细菌可以利用体内的一些物质生成抵抗抗生素的成分, 使抗生素失效, 导致出现体外敏感, 而体内耐药的情况。

        3. 一些细菌产生耐药性

        例如产超广谱B2内酰胺酶的大肠杆菌和克雷伯菌对头孢菌素及氨曲南, 沙门氏、志贺氏菌对第1、2代头孢菌素及氨基糖苷类药物的体外药敏试验有时可能呈敏感, 但临床治疗是无效的, 报告药敏结果时需要对此类结果进行修正和说明。

        4.致病菌判断不正确或者没有检出, 我们认为这才是最可能理由。

        首先, 一般医院检验科微生物实验室做细菌培养仅限于需氧非苛养菌的检测, 而对于厌氧菌、L 型细菌以及一些对氧或营养有特殊要求的细菌都不能培养出来, 如果这类细菌才是病原菌的话, 当然有理由了。另外, 对于一些有正常菌群寄生的感染, 如: 呼吸道(如痰液、咽拭子) 等, 致病菌的判定是个难题, 需要检验者具备较丰富的经验, 致病菌判断错误, 药敏与药效不符也就难免了。

        5. 药敏试验策略选择错误导致药敏结果不正确。

        例如, 根据NCCL S 规定, 非肠杆菌科革兰氏阴性杆菌除铜绿假单胞菌和不动杆菌可做纸片扩散法药敏试验外, 假单胞菌属其它细菌、嗜麦芽窄食单胞菌和其它苛养不发酵葡萄糖的革兰氏阴性杆菌的药敏试验均需用稀释法。

        6. 药敏纸片或药物浓度变化或失效, 造成假耐药情况。

        这主要是试剂质量理由, 最容易出理由的是氨苄西林、替卡西林、哌拉西林纸片和亚胺硫霉素水剂。

        7. 临床用药剂量与药敏实验的实际剂量有较大差异, 也是造成细菌药敏实验结果与临床药效不符的理由。

        8. 严格按要求做药敏试验也是很重要的, 包括选用合格的平皿、琼脂、培养基的厚度、菌液的浊度、孵育的温度及时间等。

        9.结论:

        实验室药敏结果来源于体外实验,药敏结果与临床药效出现较大差异

        2

        参考资料:

        [1]细菌药敏临床药效不符的常见原因

        [2]细菌药敏实验在临床用药中的指导意义

        教师评价

        怎么写细菌本科论文?此文是一篇关于超级细菌论文范文,为你的毕业论文写作提供有价值的参考,可用于不知道怎么写阿莫西林和头孢菌素和氨苄西林论文范文课题研究的大学硕士与本科毕业论文开题报告和文献综述及职称论文的作为参考文献资料下载.

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