What are the symptoms of MDR infection?

summary

Multidrug resistant bacteria are pathogens with multidrug resistance. Multidrug resistance, multidrug resistance, which is defined as a microbial response to three categories (such as aminoglycosides, erythromycin β－ They were resistant to more than three kinds of antibiotics at the same time, but not three kinds of antibiotics in the same class. It became a pan resistant strain and resistant to almost all antibiotics. Such as pan resistant Acinetobacter, aminoglycoside, penicillin, cephalosporin, carbapenem, tetracyclines, fluoroquinolone and sulfonamides resistance. What are the symptoms of MDR infection? Let's talk about it

What are the symptoms of MDR infection?

Multiple resistance (MDR) refers to the resistance to a variety of commonly used antimicrobial drugs at the same time. The main mechanism is the mutation of efflux membrane pump gene, followed by the change of outer membrane permeability and the production of extended spectrum enzymes. MDR-TB and mdr-mrsa of Gram-positive bacteria, as well as Acinetobacter baumannii and Pseudomonas aeruginosa that often appear in ICU were the most common, which were only sensitive to penicillins; Stenotrophomonas maltophilia was resistant to almost all antibiotics except compound sulfamethoxazole. The emergence of MDR determines the necessity of combination therapy; The high frequency of MDR strains means that the era of antimicrobial drugs is coming to an end.

The main reasons for the increasing drug resistance rate of microorganisms are: unreasonable use and abuse. For example, in the United States, 50% of them are used for human anti infection and 50% for agriculture and animal husbandry. Only 20% of them are used for hospital anti infection, while 80% are used in community. The abuse rate is 20% ~ 50%; In agriculture and animal husbandry, therapeutic application accounts for only 20%, while preventive and growth promoting application accounts for 80%, and the abuse rate is 40% ~ 80%. Every year, 40000 deaths are caused by drug-resistant bacteria. The abuse of antibiotics in China is more serious than that in the United States. The assessment of who on the abuse of antibiotics in China is that 97% of the patients with viral bronchial infection in China use antibiotics; In the primary health care system, 30% - 60% of patients use antibiotics.

There are many mechanisms of bacterial resistance to antibiotics, the most important of which are inactivated enzymes, such as β- The production of lactamase and aminoglycoside inactivating enzyme; The second was the change of target sites, such as the change of penicillin binding proteins (PBPs); In other cases, the permeability of cell membrane was changed, which made it difficult for drugs to enter; The bacterial pumping system is increased and enhanced to discharge the drugs that have entered the bacteria; More than two mechanisms can be initiated at the same time.

matters needing attention

1. Strictly manage MDR infected patients (and carriers) and set up special rooms and areas for isolation; 2. Medical care for MDR infected patients was provided by well-trained full-time medical staff, who were temporarily transferred from work when they were found to be carriers; 3. Wash hands with disinfectant before checking each patient, and change masks, white coats or gloves as needed; 4. Strictly disinfect the environment of the ward every day; 5. Re education of "cautious and rational use of antibiotics" for medical staff; 6. The drug-resistant bacteria and MDR were monitored according to the unified operating procedures in various regions at home and abroad;