目的:系统评价氯己定全身擦浴对重症监护室(ICU)病人多重耐药菌感染的预防效果。方法:检索the Cochrane Library、PubMed、Web of Science、EMbase、中国知网、万方数据库、维普数据库、中国生物医学文献数据库中关于氯己定全身擦浴预防...目的:系统评价氯己定全身擦浴对重症监护室(ICU)病人多重耐药菌感染的预防效果。方法:检索the Cochrane Library、PubMed、Web of Science、EMbase、中国知网、万方数据库、维普数据库、中国生物医学文献数据库中关于氯己定全身擦浴预防ICU病人多重耐药菌感染效果的中英文文献。由2名研究者根据纳入与排除标准独立筛选文献、质量评价及提取资料,采用Stata 16.0软件进行Meta分析。结果:最终纳入11项研究共23090例病人。Meta分析结果显示,与常规温水或肥皂水擦浴比较,氯己定能降低ICU病人多重耐药菌感染(OR=0.770,P<0.001)。其中氯己定全身擦浴能降低耐万古霉素肠球菌(VRE)(OR=0.664,P=0.004)及耐碳青霉烯类铜绿假单胞菌(CRPA)(OR=0.442,P=0.034)的感染发生风险,但不能降低耐甲氧西林金黄色葡萄球菌(MRSA)(OR=0.852,P=0.193)及耐碳青霉烯类鲍曼不动杆菌(CRAB)的感染发生风险(OR=0.888,P=0.537)。结论:现有证据显示,氯己定全身擦浴能降低ICU病人多重耐药菌感染,但仅对部分耐药菌有效。展开更多
目的了解万古霉素耐药肠球菌（Vancomycin—Resistant Enterococci，VRE）接合型转座子遗传标记、I类整合子遗传标记存在状况。方法对7株VRE菌进行接合型转座子遗传标记（intTn916／Tnl545转座酶基因）、I类整合子遗传标记（intI1基因...目的了解万古霉素耐药肠球菌（Vancomycin—Resistant Enterococci，VRE）接合型转座子遗传标记、I类整合子遗传标记存在状况。方法对7株VRE菌进行接合型转座子遗传标记（intTn916／Tnl545转座酶基因）、I类整合子遗传标记（intI1基因检测）。结果7株VRE中3株intTn916/Tnl545阳性，无int I 1基因检出。结论VRE可携带接合型转座子。展开更多
The first described vancomycin resistant enterococci (VRE) was about twenty years ago. Recently VRE have been reported by many clinics. However endocarditis due to VRE is still a rare entity and there are only a few c...The first described vancomycin resistant enterococci (VRE) was about twenty years ago. Recently VRE have been reported by many clinics. However endocarditis due to VRE is still a rare entity and there are only a few cases reported in the literature. We are reporting a 59-year-old male patient with chronic renal failure who was on hemodialysis. He presented with a sudden onset of fever, tachycardia and respiratory distress. The performed echocardiography revealed vegetations on the mitral and aortic valves. As he was diagnosed to have infective endocarditis the patient was put on ampicillin and gentamicin therapy. He underwent an emergent mitral and aortic valve surgery due to ensued heart failure. While he was still on ampicillin and gentamicin therapy, E. gallinarum, which was resistant to vancomycin (MIC = 8 mg/L), was isolated from the surgical valve specimens and hence his antibiotic regime was switched to teicoplanin (MIC < 0.5 mg/L). 28 days after teicoplanin therapy the patient was discharged with free of symptoms and any complication. This patient is presented as an example for an endocarditis with an unusual type of enterococci.展开更多
文摘目的了解万古霉素耐药肠球菌（Vancomycin—Resistant Enterococci，VRE）接合型转座子遗传标记、I类整合子遗传标记存在状况。方法对7株VRE菌进行接合型转座子遗传标记（intTn916／Tnl545转座酶基因）、I类整合子遗传标记（intI1基因检测）。结果7株VRE中3株intTn916/Tnl545阳性，无int I 1基因检出。结论VRE可携带接合型转座子。
文摘The first described vancomycin resistant enterococci (VRE) was about twenty years ago. Recently VRE have been reported by many clinics. However endocarditis due to VRE is still a rare entity and there are only a few cases reported in the literature. We are reporting a 59-year-old male patient with chronic renal failure who was on hemodialysis. He presented with a sudden onset of fever, tachycardia and respiratory distress. The performed echocardiography revealed vegetations on the mitral and aortic valves. As he was diagnosed to have infective endocarditis the patient was put on ampicillin and gentamicin therapy. He underwent an emergent mitral and aortic valve surgery due to ensued heart failure. While he was still on ampicillin and gentamicin therapy, E. gallinarum, which was resistant to vancomycin (MIC = 8 mg/L), was isolated from the surgical valve specimens and hence his antibiotic regime was switched to teicoplanin (MIC < 0.5 mg/L). 28 days after teicoplanin therapy the patient was discharged with free of symptoms and any complication. This patient is presented as an example for an endocarditis with an unusual type of enterococci.
