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产超广谱β内酰胺酶肠杆菌感染急诊诊疗中国专家共识

2020-12-30 中华急诊医学杂志.2020.29(12):1520-1526.

超广谱β 内酰胺酶

超广谱β 内酰胺酶（extended-spectrumβ-lactam, ESBLs）是由质粒介导的能水解青霉素类、头孢菌素及单环酰胺类等β- 内酰胺类抗菌药物的&bet

中文标题：

产超广谱β内酰胺酶肠杆菌感染急诊诊疗中国专家共识

发布机构：

发布日期：

2020-12-30

简要介绍：

超广谱β 内酰胺酶（extended-spectrumβ-lactam, ESBLs）是由质粒介导的能水解青霉素类、头孢菌素及单环酰胺类等β- 内酰胺类抗菌药物的β- 内酰胺酶，其对碳青霉烯类和头霉素类水解能力弱。ESBLs 主要由肠杆菌科细菌产生，以肺炎克雷伯菌、大肠埃希菌、变形杆菌最为常见，产ESBLs 肠杆菌（extended-spectrumβ-lactam,enterobacteriaceae, ESBL-E）也成为急危重患者耐药菌感染的主要致病菌之一。急诊患者有其独特的临床特点：（1）病情复杂，基础疾病和并发症多，病变可累及多个脏器，涉及多个专科。（2）多为老年慢性病、营养不良和免疫功能低下（肿瘤、免疫系统疾病、糖尿病等）患者，滞留在急诊接受治疗。（3）病情危重，多需要有创抢救和治疗（机械通气、各种导管的留置，肾脏替代治疗等），操作远多于普通住院患者。上述特点造成急诊患者ESBL-E感染发生率较高，为此ESBL-E 感染急诊诊疗中国专家组结合大量循证医学证据，采用德尔菲调查法制定共识，针对急诊ESBL-E 感染患者诊疗密切相关的问题给予指导和推荐。

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  1. [GetPortalCommentsPageByObjectIdResponse(id=1082981, encodeId=86a41082981d0, content=学习学习, beContent=null, objectType=guider, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=17352470348, createdName=124372c4m12暂无昵称, createdTime=Wed Dec 22 10:02:03 CST 2021, time=2021-12-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1070710, encodeId=ff2d10e071045, content=有用，感谢平台！, beContent=null, objectType=guider, channel=null, level=null, likeNumber=96, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/KWhSPGbJlOTjdyUnSckyLu3BI5gQN0GIIX1Aob1B1Ijcqz86r3bg7kmAjAmfXJbUryR2ehK28gFiaC7CWlcBiahg/132, createdBy=327b5320277, createdName=clj, createdTime=Tue Nov 16 11:30:21 CST 2021, time=2021-11-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1066418, encodeId=329a10664189d, content=学习了，辛苦分享, beContent=null, objectType=guider, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e0d35687893, createdName=ms8000001926821358, createdTime=Tue Nov 02 23:01:27 CST 2021, time=2021-11-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1002979, encodeId=03e710029e903, content=学习了，辛苦分享, beContent=null, objectType=guider, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210727/51366758407c4e3f9af8c93800719522/8e0fdb360ef449899ef35ff3151c02fd.jpg, createdBy=588b5555557, createdName=ms2000000034292568, createdTime=Tue Jul 27 12:14:37 CST 2021, time=2021-07-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=972306, encodeId=ec409e2306a3, content=学习了, beContent=null, objectType=guider, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=16393054189, createdName=yaofeng85598283, createdTime=Wed Jun 09 22:36:56 CST 2021, time=2021-06-09, status=1, ipAttribution=)]
    2021-12-22 124372c4m12暂无昵称

    学习学习

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=1082981, encodeId=86a41082981d0, content=学习学习, beContent=null, objectType=guider, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=17352470348, createdName=124372c4m12暂无昵称, createdTime=Wed Dec 22 10:02:03 CST 2021, time=2021-12-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1070710, encodeId=ff2d10e071045, content=有用，感谢平台！, beContent=null, objectType=guider, channel=null, level=null, likeNumber=96, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/KWhSPGbJlOTjdyUnSckyLu3BI5gQN0GIIX1Aob1B1Ijcqz86r3bg7kmAjAmfXJbUryR2ehK28gFiaC7CWlcBiahg/132, createdBy=327b5320277, createdName=clj, createdTime=Tue Nov 16 11:30:21 CST 2021, time=2021-11-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1066418, encodeId=329a10664189d, content=学习了，辛苦分享, beContent=null, objectType=guider, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e0d35687893, createdName=ms8000001926821358, createdTime=Tue Nov 02 23:01:27 CST 2021, time=2021-11-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1002979, encodeId=03e710029e903, content=学习了，辛苦分享, beContent=null, objectType=guider, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210727/51366758407c4e3f9af8c93800719522/8e0fdb360ef449899ef35ff3151c02fd.jpg, createdBy=588b5555557, createdName=ms2000000034292568, createdTime=Tue Jul 27 12:14:37 CST 2021, time=2021-07-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=972306, encodeId=ec409e2306a3, content=学习了, beContent=null, objectType=guider, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=16393054189, createdName=yaofeng85598283, createdTime=Wed Jun 09 22:36:56 CST 2021, time=2021-06-09, status=1, ipAttribution=)]
    2021-11-16 clj

    有用，感谢平台！

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=1082981, encodeId=86a41082981d0, content=学习学习, beContent=null, objectType=guider, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=17352470348, createdName=124372c4m12暂无昵称, createdTime=Wed Dec 22 10:02:03 CST 2021, time=2021-12-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1070710, encodeId=ff2d10e071045, content=有用，感谢平台！, beContent=null, objectType=guider, channel=null, level=null, likeNumber=96, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/KWhSPGbJlOTjdyUnSckyLu3BI5gQN0GIIX1Aob1B1Ijcqz86r3bg7kmAjAmfXJbUryR2ehK28gFiaC7CWlcBiahg/132, createdBy=327b5320277, createdName=clj, createdTime=Tue Nov 16 11:30:21 CST 2021, time=2021-11-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1066418, encodeId=329a10664189d, content=学习了，辛苦分享, beContent=null, objectType=guider, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e0d35687893, createdName=ms8000001926821358, createdTime=Tue Nov 02 23:01:27 CST 2021, time=2021-11-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1002979, encodeId=03e710029e903, content=学习了，辛苦分享, beContent=null, objectType=guider, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210727/51366758407c4e3f9af8c93800719522/8e0fdb360ef449899ef35ff3151c02fd.jpg, createdBy=588b5555557, createdName=ms2000000034292568, createdTime=Tue Jul 27 12:14:37 CST 2021, time=2021-07-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=972306, encodeId=ec409e2306a3, content=学习了, beContent=null, objectType=guider, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=16393054189, createdName=yaofeng85598283, createdTime=Wed Jun 09 22:36:56 CST 2021, time=2021-06-09, status=1, ipAttribution=)]
    2021-11-02 ms8000001926821358

    学习了，辛苦分享

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1082981, encodeId=86a41082981d0, content=学习学习, beContent=null, objectType=guider, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=17352470348, createdName=124372c4m12暂无昵称, createdTime=Wed Dec 22 10:02:03 CST 2021, time=2021-12-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1070710, encodeId=ff2d10e071045, content=有用，感谢平台！, beContent=null, objectType=guider, channel=null, level=null, likeNumber=96, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/KWhSPGbJlOTjdyUnSckyLu3BI5gQN0GIIX1Aob1B1Ijcqz86r3bg7kmAjAmfXJbUryR2ehK28gFiaC7CWlcBiahg/132, createdBy=327b5320277, createdName=clj, createdTime=Tue Nov 16 11:30:21 CST 2021, time=2021-11-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1066418, encodeId=329a10664189d, content=学习了，辛苦分享, beContent=null, objectType=guider, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e0d35687893, createdName=ms8000001926821358, createdTime=Tue Nov 02 23:01:27 CST 2021, time=2021-11-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1002979, encodeId=03e710029e903, content=学习了，辛苦分享, beContent=null, objectType=guider, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210727/51366758407c4e3f9af8c93800719522/8e0fdb360ef449899ef35ff3151c02fd.jpg, createdBy=588b5555557, createdName=ms2000000034292568, createdTime=Tue Jul 27 12:14:37 CST 2021, time=2021-07-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=972306, encodeId=ec409e2306a3, content=学习了, beContent=null, objectType=guider, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=16393054189, createdName=yaofeng85598283, createdTime=Wed Jun 09 22:36:56 CST 2021, time=2021-06-09, status=1, ipAttribution=)]
    2021-07-27 ms2000000034292568

    学习了，辛苦分享

    0

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    2021-06-09 yaofeng85598283

    学习了

    0

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