Contents 1 Pinyin 2 English reference 3 Overview 4 Disease name 5 English name 6 Classification 7 ICD number 8 Epidemiology 8.1 Source of infection 8.2 Route of infection 8.3 Susceptible groups 9 Cause 10 Pathogenesis 11 Enterobacteriaceae pneumonia Clinical manifestations 12 Complications of Enterobacter pneumonia 13 Laboratory tests 13.1 Blood picture 13.2 Urine routine, renal function and liver function 13.3 Sputum bacterial culture 14 Auxiliary examination 15 Diagnosis 16 Differential diagnosis 17 Treatment of Enterobacter pneumonia 17.1 Treatment principles 17.2 Antimicrobial treatment 18 Prognosis 19 Prevention of Enterobacter pneumonia 20 Related drugs 21 Related examinations are attached: 1 Chinese patent medicines for the treatment of Enterobacter pneumonia 2 Enterobacter pneumonia related drugs 1 Pinyin
cháng gǎn jūn fèi yán 2 English reference
Enterobacter pneumonia 3 Overview
Enterobacter pneumonia used to be extremely rare. recent decades. With the increasing use of broad-spectrum antibiotics and respiratory medical devices, Enterobacteriaceae pneumonia has accounted for 9.4% of nosocomial pneumonia, ranking fourth after Pseudomonas aeruginosa pneumonia, Staphylococcus aureus pneumonia and Klebsiella pneumonia. Among them, Enterobacter cloacae and Enterobacter aerogenes are the most common. Clinically, Enterobacteriaceae pneumonia mostly occurs in people who are weak or immunosuppressed, and is easily caused by contaminated medical equipment. It is often accompanied by bacteremia and poor response to multiple antibiotic treatments.
Enterobacteriaceae pneumonia is similar to other gram-negative bacillus pneumonias. The onset of illness is sudden, with sudden onset of chills and fever. The body temperature is usually between 37.7 and 38.8°C. The cough is obvious, with a large amount of sputum, which is mucopurulent. However, unlike Klebsiella pneumonia, hemoptysis and bloody sputum are rare. If the disease is extensive, there may be difficulty breathing. Physical examination may reveal shortness of breath and cyanosis. 4 Disease name
Enterobacter pneumonia
5 English name
enterobacter pneumonia 6 Classification
Respiratory Diseases> Infectious Diseases> Bacterial Pneumonia 7 ICD number
J15.5 8 Epidemiology 8.1 Source of infection
Enterobacter is a bacterial infection, and carriers are the main source of infection. Bacterial transmission is rare in the normal population, but the infection rate among doctors and nurses in hospitals is higher than that in the general population. Critically ill patients in the hospital are the main carriers. Mayhall et al. reported multiple cases of Enterobacter cloacae infection in a burn unit. During the outbreak, 50% of the patients carried this bacterium. For patients with Enterobacteriaceae colonizing the intestines or oropharynx, they themselves may be the source of endogenous infection with Enterobacteriaceae pneumonia. In addition, medical devices such as nebulizers, oxygen humidification bottles and suction machines in hospital wards may become sources of infection. 8.2 Route of infection
(1) Respiratory inhalation: including aspiration of nasopharyngeal secretions and direct inhalation of Enterobacter bacteria in the air, which is the main infection route of Enterobacter pneumonia. It is generally believed that bacteria contaminated through eating or other means often first colonize the oropharynx. The oropharyngeal secretions are then aspirated into the lower respiratory tract. This route of infection is rare in healthy people. But in patients with severe disease, massive and persistent reproduction may occur. Someone observed patients in the intensive care unit and found that 22% of patients who were using ventilators, had heart failure after surgery, were in shock, or were receiving antibiotic treatment had gram-negative bacilli growing in the oropharynx within 24 hours. At the end of the week, it was as high as 45%, among which the proportion of Enterobacter aerogenes increased significantly. Respiratory Enterobacteriaceae accounted for 68% of patients with respiratory failure caused by various causes.
(2) Infection from contaminated equipment: Respiratory equipment is an important infection route causing Enterobacteriaceae pneumonia. Among respiratory treatment equipment, about 80% of atomization or humidification devices are contaminated by pathogenic bacteria, among which Enterobacter cloacae, Enterobacter aerogenes and Enterobacter agglomerans are also common contaminating bacteria. Since nebulizers with liquid storage can produce liquid particles as small as 1 mm, which can reach deep into the lower respiratory tract, literature reports that nebulizers have the greatest chance of contamination. In addition, oxygen humidification bottles are also an important transmission route. In 1993, an oxygen humidification bottle in a domestic hospital was contaminated by Enterobacter cloacae, causing an outbreak of Enterobacter cloacae pneumonia in 31.3% of inpatients.
(3) Hematogenous dissemination: Enterobacteriaceae are an important cause of bacteremia and sepsis in some hospitals, especially surgical intensive care units. Early literature reports were 3.7% of septicemia caused by Gram-negative bacilli. twenty three%. In recent years, the incidence rate seems to be increasing and can be as high as 40%.
Enterobacteriaceae pneumonia may therefore be a pulmonary manifestation of systemic Enterobacteriaceae infection. 8.3 Susceptible groups
Enterobacteriaceae are opportunistic pathogens. Only when the patient's local and systemic resistance is low and the normal flora is imbalanced will they colonize and multiply in the lower respiratory tract and cause infection.
(1) Patients who have recently undergone surgery: Relevant data show that the incidence of Enterobacter pneumonia is not only related to surgery, but also to the type of surgery and the time of surgery. The incidence rate of pneumonia in surgical patients is 3.91 times higher than that in medical patients, and the incidence rate in patients undergoing combined thoracoabdominal surgery can be as high as ten times.
(2) Patients with primary diseases prone to aspiration: disorders of consciousness caused by general anesthesia, cerebrovascular accidents, drug overdose, alcoholism, and brain injury; neck, pharynx and esophagus Those whose disease affects their swallowing function may inhale Enterobacter bacteria colonizing the oropharynx and cause infection. For example, nasogastric tubes provide convenient conditions for Enterobacteriaceae to enter the lower respiratory tract. Survey results show that the incidence of pneumonia is 21 times higher in those with mechanical ventilation than in those without mechanical ventilation. Even if great attention is paid to instrument disinfection, the incidence of nosocomial pneumonia, including Enterobacteriaceae, cannot be further reduced.
(3) People with low systemic immune function: some elderly people, patients with chronic diseases and diabetes, cardiovascular disease, and renal failure; cancer patients receiving radiotherapy and chemotherapy; organ transplantation and connective tissue diseases using antimetabolite drugs; Corticosteroid treatment for hematological diseases and chronic alcoholism can cause a decline in immune function and lead to Enterobacteriaceae infection.
(4) Patients who use a large amount of antibiotics or neutralize gastric acid: the balance of normal flora in the body is destroyed or the pH of the stomach is increased, leading to the proliferation of a large number of opportunistic pathogenic bacteria such as Enterobacteriaceae. 9 Causes
Enterobacteriaceae are divided into Enterobacter cloacae (E. cloacae), Enterobacter aerogenes (E. aerogenes), Enterobacter agglomerans (E. agglomerans), Enterobacter jegophili (E. gergoviae), Enterobacter sakazakii (E.sakazakii) and Enterobacter taylorae (E.taylorae). Among them, Enterobacter cloacae and Enterobacter aerogenes are clinically important opportunistic pathogens, which can cause pneumonia, sepsis, urinary tract infection, and meningitis; Enterobacter agglomerans is an important pathogenic agent of nosocomial infections and can contaminate infusions and cause Sepsis and other infections.
Bacteria of the genus Enterobacter are widely distributed in the natural environment. Found in soil, sewage, rotting vegetables and dairy products. Enterobacter cloacae and Enterobacter aerogenes can colonize the gastrointestinal tract and respiratory tract and are part of the normal flora.
Enterobacteriaceae have similar biological characteristics. The representative bacterium is Enterobacter cloacae. The bacterial cells are 1.2 to 3.2 μm long and 0.6 to 1.0 μm wide. It is powered and has flagella all over its body. Most ferments of mannitol, sorbitol, lactose, sucrose, arabinose and rhamnose do not produce hydrogen sulfide and indole. VP reaction is positive, MR reaction is negative, gluconate is positive, and ornithine decarboxylase is produced. All bacteria grow well on ordinary culture media. The colonies of each bacterial species are not characteristic and require a series of biochemical reactions to identify them.
Enterobacteriaceae can be typed by serum, bacteriocins, biochemical tests, phages and other methods. Various methods have different functions, but they can play a role in mutual verification and compensation. In the Central Public Health Laboratory of the United States, the most reliable serological method is used as the main method to identify bacterial strains. Bacteriophage typing was used for further typing of strains of the same serotype. These classification methods have been proven to be effective in most cases. However, in some cases, biotyping can be a useful, confirmatory method. Currently, Enterobacter cloacae is divided into 53 O antigens and 57 H antigens, and 79 serotypes are classified among 170 strains. 10 Pathogenesis
Except for those with hematogenous dissemination, it is generally believed that Enterobacteriaceae bacteria, including Enterobacteriaceae, are different from non-Enterobacteriaceae bacteria such as Pseudomonas aeruginosa. Before entering the lower respiratory tract, , often first reside in the oropharynx, and then reach the lower respiratory tract through inhalation or direct spread.
Whether bacteria can enter the lower respiratory tract and cause infection depends on the number and duration of bacteria adhering to the mucosa. The more bacteria that stick and the longer they last, the greater the chance of infection. According to research, in addition to the immune function of the patient's systemic and lower respiratory tract, the structure of the airway epithelium, the surface structure of Enterobacter bacteria and the local microenvironment are all important factors that affect adhesion.
In terms of airway epithelium, many critical diseases lead to an increase in bacterial receptors on epithelial cells, thereby increasing bacterial adhesion; abnormal ciliary function of airway epithelial cells reduces the clearance of invading bacteria; mucosal epithelium Reducing the concentration of fibronectin on the cell surface reduces the blocking of bacterial binding sites, which can increase bacterial colonization in the lower respiratory tract. The airway mucosa is damaged during intubation or suctioning, the basement membrane is exposed, and bacteria may adhere to the connective tissue under the mucosa.
In terms of bacteria, the number of bacterial pili, the ability to secrete mucus, the decomposing activity of fibronectin and the substances produced by it, such as ciliary stabilizing substances, proteases and mucin degradation products, can all Affects colonization in the lower respiratory tract. Most strains of Enterobacter have type I pili, and a few can also produce type III pili and/or MR adsorbins, which have strong adhesion.
In addition, some bacteria can produce substances that affect ciliary function and reduce bacterial clearance. Enterobacteriaceae may also break down fibronectin to expose bacterial binding sites on the surface of mucosal epithelial cells.
In terms of the airway mucosal microenvironment, it is mainly due to changes in the chemical composition and properties of airway secretions that affect bacterial colonization. First, certain primary diseases increase the pH of airway secretions and increase bacterial adhesion. Secondly, when airway inflammation occurs, neutral elastase breaks down IgA and fibronectin, increasing bacterial adhesion.
Pathological changes: Enterobacteriaceae pneumonia, most of which are bronchopneumonia. Multiple sites are often involved, more than half are bilateral, and leaf consolidation is less common. In people infected by inhalation, the lower lungs are more common. Inflammation starts from the bronchi and causes purulent inflammation, consolidation and necrosis of surrounding tissues through the walls of small bronchial tubes, forming multiple micro-abscesses. Those caused by hematogenous dissemination first produce perivascular infiltration and small nodular lung tissue infarcts, followed by massive neutrophil infiltration and multiple microabscesses.
Regardless of how small abscesses are caused, if treatment is delayed, the small abscesses may merge to form a large abscess. If subpleural involvement occurs, purulent pleurisy may also occur. 11 The clinical manifestations of Enterobacter pneumonia
Enterobacterial pneumonia is similar to other gram-negative bacilli pneumonia. The onset of illness is sudden, with sudden onset of chills and fever. The body temperature is usually between 37.7 and 38.8°C. The cough is obvious, with a large amount of sputum, which is mucopurulent. However, unlike Klebsiella pneumonia, hemoptysis and bloody sputum are rare. If the disease is extensive, there may be difficulty breathing.
Physical examination may reveal shortness of breath and cyanosis. Moist rales are often heard in both lungs, and signs of pulmonary consolidation are rare. In cases of blood-borne infection, pulmonary signs are sometimes absent, but manifestations of extrapulmonary infection such as urinary tract and digestive tract are often found. 12 Complications of Enterobacter pneumonia
One of the common complications of Enterobacter pneumonia is bacteremia. According to literature reports, 11% of Enterobacteriaceae bacteremias of various causes are caused by respiratory tract infection and then develop into bacteremia, second only to those with abdominal organ and urinary tract infections. Therefore, when it is suspected that the pulmonary infection is caused by hematogenous dissemination or is accompanied by bacteremia, blood culture should be performed. If Enterobacter is positive, the diagnosis can be confirmed. 13 Laboratory tests 13.1 Blood picture
The total number of white blood cells may be increased or normal, but neutrophils are often significantly increased, and anemia is more common. 13.2 Urine routine, renal function and liver function
In patients with Enterobacter sepsis combined with pneumonia, urine routine, renal function and liver function may be abnormal. 13.3 Sputum bacterial culture
Sputum bacterial culture is the only means to diagnose Enterobacter pneumonia. Clinically expectorated sputum is contaminated by other bacteria in the oropharynx, and specimens can be obtained by transcricothyroid puncture, percutaneous lung puncture, and fiberoptic bronchoscopy. If sputum culture is used, the specimen needs to be processed before culture and an appropriate selection medium is applied to improve the reliability of the results.
(1) Treatment of expectoration: The coughed up sputum is first washed with physiological saline 5 to 9 times (which can reduce contaminating bacteria by an average of 100 times), and then directly smeared. If the leukocytes are >25 and the squamous epithelial cells are <10 under the low power field, then add 1% to 2% protease or acetylcysteine ??to the sputum and incubate it at 37°C. When the bacterial concentration is >106/ml, the culture is considered to be of diagnostic significance, and a series of biochemical reactions and typing are further conducted to determine the bacterial species, strain and type.
(2) Selective medium: Because the concentration of Enterobacteriaceae in sputum samples is sometimes low, a selective medium is needed to increase the positive rate of culture. The components of the selection medium are: 2% cellobiose, 0.1% yeast extract, 0.03% sodium deoxycholic acid cholate, 10 μg/ml cephalosporin, 1% agar and Andrade's indicator. After being cultured at 37°C for 24 hours, most Enterobacter cloacae produce pigments due to changes in pH, and most fecal coliforms grow slowly or not at all. Enterobacter aerogenes can also grow on this medium. 14 Auxiliary examinations
Chest X-ray examination often shows bilateral lower lung bronchopneumonia, but in a few cases only increased lung markings are seen without obvious lung parenchymal infiltration. In a small number of patients with inhalation infection, a large area of ??consolidation can be seen in the posterior segment of the upper lobe and lower lobe of the right lung, with cavities in between, but this is much less common than Klebsiella pneumonia. In cases of blood-borne infection, the chest X-ray shows irregular nodules with increased density, 4 to 10 mm in diameter, spread throughout the lungs. If the disease progresses, the nodules will increase in size and fuse. 15 Diagnosis
The clinical manifestations of Enterobacteriaceae pneumonia are not characteristic and are similar to other gram-negative bacilli pneumonias. It is difficult to diagnose based on clinical manifestations alone. The diagnosis is based on the occurrence of fever, increased bronchial purulent secretions, increased leukocytosis, lesions in the lungs, or new infiltrates based on the original lung lesions in high-risk groups during hospitalization. Confirmation and differential diagnosis rely on bacteriological examination. 16 Differential diagnosis
It should be differentiated from gram-negative bacilli pneumonia such as Pseudomonas aeruginosa pneumonia, Klebsiella pneumonia, Haemophilus influenzae, Haemophilus pneumonia, and Proteus pneumonia. 17 Treatment of Enterobacter pneumonia 17.1 Treatment principles
(1) General treatment: including rest, nursing, diet, oxygen inhalation, antitussive and expectorant and other general treatments.
(2) Antimicrobial treatment: Select antibiotics that target pathogenic bacteria and combine them with drug susceptibility testing.
(3) Treatment of complications: Timely puncture or drainage of complications such as empyema. If the function of other organs is affected, corresponding treatment should be carried out.
(4) Treatment of primary disease: The nature of the primary disease is often an important factor in determining the prognosis of Enterobacter bacterial infection. Therefore, while antibacterial treatment is being carried out, the primary disease should be actively treated. 17.2 Antimicrobial treatment
(1) Resistance of Enterobacteriaceae: In recent years, the resistance of Enterobacteriaceae to antibiotics has gradually increased. There is strong resistance to first-generation cephalosporins, Cloacae and Enterobacter aerogenes, but some Enterobacter agglomerans and Enterobacter sakazhi are still sensitive. In 1970, Oale et al. compared the resistance of Enterobacter cloacae and Enterobacter aerogenes to 11 antibiotics and found that the test strains were all sensitive to gentamicin. In the mid-1970s, Moellering et al. studied more than 3,000 strains of Enterobacteriaceae isolated and found that 10% were resistant to gentamicin and 2% were resistant to amikacin. In 1994, a domestic group reported that the resistance rate of Enterobacteriaceae to 10 commonly used clinical antibiotics was over 40% except for amikacin.
Therefore, some people advocate that in the treatment of Enterobacteriaceae pneumonia, a combination of two antibiotics should always be selected based on drug susceptibility results, preferably anti-pseudomonal penicillin and aminoglycoside antibiotics. However, the new generation of cephalosporins and quinolones applied in recent years also have good effects on Enterobacteriaceae and can be selected as appropriate.
(2) Selection of antibiotics:
① Penicillins: A. Piperacillin: In recent years, domestic literature reports that the resistance rate of Enterobacteriaceae to it is almost 100% . Therefore, unless drug susceptibility results are confirmed, it should not be used as the first choice drug to treat Enterobacteriaceae pneumonia. Commonly used dosage: 4-8g per day for mild cases, double for severe infections, applied in 4 times. B. Ticarcillin (Penicillium carboxythiophene): Its antibacterial spectrum is similar to that of carbenicillin, but it is not resistant to β-lactamase. The concentration of pleural effusion is half of the blood concentration, and the sputum concentration is lower. A domestic group reported that the resistance rate of Enterobacteriaceae to it was 100%. It is generally believed that for Enterobacteriaceae infections, it is often necessary to combine it with aminoglycosides. Adult dosage: 200~300mg/(kg·d), given in divided doses.
Others such as temocillin (carboxythiophene methicillin) and carincillin (indanate carbenicillin) can also be used.
② Cephalosporins: A. Cefotaxime (claforan): It has powerful broad-spectrum bactericidal and bacteriostatic effects and can resist beta-lactamases produced by a variety of bacteria, especially Enterobacteriaceae. The role is particularly prominent. Its metabolite acetylcefotaxime also has antibacterial activity and has a synergistic effect with this product. Usage: 1~2g/d, 2 times/d, for severe infection, 12g/day, divided into 3 to 4 times. B. Ceftizoxime (cefotaxime): The antibacterial spectrum is similar to that of cefotaxime, and it is stable against β-lactamase. When combined with aminoglycoside antibiotics, the efficacy is significantly enhanced. The total clinical effectiveness is over 90%. Adults: 2~4g/d, severe cases 10~12g/d, divided into 2~4 times. C. Oxycephalosporin (Hydroxycarboxylic acid): It is a partially synthetic broad-spectrum antibiotic that is highly stable against β-lactamase produced by Enterobacteriaceae bacteria. It has a strong antibacterial effect on Gram-negative bacilli including Enterobacteriaceae. Enterobacteriaceae resistant to gentamicin, tobramycin, ampicillin and cefotaxime are still sensitive to this product. The concentration in various exudates is high and long-lasting. For various infections caused by Enterobacteriaceae, the total effective rate is 83.2%. Dosage: 1 to 4g/d, divided into 2 intramuscular or intravenous injections.
Others such as: ceftriaxone (ceftriaxome), ceftazidime (cefortam), cefoperazone (cefoperazone), aztreonam (thioxime monobactin) all have certain effects and can be selected according to the situation. .
③Aminoglycosides: Among the aminoglycoside antibiotics, gentamicin, tobramycin and amikacin are commonly used drugs for the treatment of Enterobacteriaceae infections. Domestic reports indicate that the resistance rate of gentamicin to gentamicin is 40.9%, so it is rarely used clinically. The resistance rate of amikacin was low, 4.84%. The commonly used dosages of tobramycin and amikacin are 160-240mg and 400-800mg respectively, divided into divided intramuscular injections.
New drugs used in recent years include: sisomicin (sisomicin), netilmicin (ethyl sisomicin), astimicin (fortimycin), etc.
④ Thiamphenicols: Imipenem/cilastatin sodium (tienam) is a thiamphenicol derivative that is extremely stable against β-lactamase. It is less effective against Enterobacteriaceae than cefotaxime and cefotaxime. The lungs have one of the highest concentrations, followed by sputum. The effective rate against lung infection is over 80%. Usage: 0.25~1.0g, intravenous infusion or intramuscular injection 2~4 times a day.
⑤Fluoroquinolones: A. Ciprofloxacin: The antibacterial spectrum is similar to norfloxacin. For the treatment of more severe respiratory infections, it is comparable to third-generation cephalosporins. A group of domestic drug susceptibility results show that Enterobacteriaceae bacteria are 100% sensitive to this product. However, it has recently been reported that bacteria develop resistance to this drug quickly. Dosage: intravenous injection of 0.1~0.2g, 2 times/d.
B. Ofloxacin (ofloxacin): has a broad antibacterial spectrum and has a strong antibacterial effect on Enterobacteriaceae and other bacteria. The clinical effectiveness and bacterial clearance rate for various infectious diseases are over 96%. Usage: 200~600mg/d, orally divided into 2 times. C. Pefloxacin (mefloxacin): It has broad-spectrum antibacterial effects and has strong antibacterial effects on Enterobacteriaceae. Usage: Take the first dose of 800mg orally, and then take 400mg each time, morning and evening with meals. Intravenous infusion: 400mg/time, 2 times in the morning and evening. 18 Prognosis
The prognosis is poor for those who are old and frail, have severe underlying diseases, and have low immune function. 19 Prevention of Enterobacter pneumonia
1. Reduce the preventive application of antibiotics? According to research, the preventive application of antibiotics, especially cephalosporin antibiotics, can increase the carriage rate of Enterobacteriaceae in hospitalized patients. Therefore, reducing the use of antibiotic prophylaxis can prevent the occurrence of Enterobacteriaceae pneumonia.
2. Topical application of non-absorbable oral antibiotics? Reducing the colonization of Enterobacteriaceae in the oropharynx and gastrointestinal tract can reduce the occurrence of Enterobacteriaceae infections in patients in ICU.
3. Prevent local colonization of Enterobacteriaceae from developing into infection? Some studies have shown that the application of active or passive immune drugs can prevent colonized Enterobacteriaceae from developing into infection, but most of them are currently in the experimental stage. .
4. To prevent the spread of infection between patients? Medical staff should pay attention to washing their hands and perform strict aseptic operations when performing respiratory care and treatment.
5. Suspected outbreak of infection? Carry out typing immediately to determine corresponding control measures. 20 Related drugs
Oxygen, mannitol, sorbitol, glucose, acetylcysteine, cysteine, cystine, cholic acid, gentamicin, amikacin, penicillin, Piperacillin, ticarcillin, carbenicillin, temocillin, methicillin, caribacillin, cefotaxime, ceftizoxime, laoxycephalosporin, tobramycin, ampicillin, ceftriaxone, ceftazidime, Cefoperazone, aztreonam, cisomicin, netilmicin, asmicin, thiamphenicol, imipenem, cilastatin, imipenem/cilastatin sodium, cyclostatin Profloxacin, norfloxacin, ofloxacin, pefloxacin 21 related examinations
Sputum bacterial culture, cystine Zeguilongshuang, a Chinese patent medicine for the treatment of Enterobacteriaceae pneumonia
External experiments have shown that Zegui Longshuang also has a good inhibitory effect on the growth of Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Staphylococcus epidermidis... Niiganning Granules
Ding has significant inhibitory effects on Sarcina, Staphylococcus aureus, hemolytic Streptococcus, Pneumococcus, Typhoid Bacillus, Shigella dysenteriae, and Pseudomonas aeruginosa... Purple Gold Ingot
Bacteria It has inhibitory effect. Galla gallnut has a significant protective effect against Staphylococcus aureus, Streptococcus, Pneumococcus, typhoid and paratyphoid bacilli, dysentery bacilli, anthrax, diphtheria... Marching Powder
Infections. The ministerial drug borneol is effective against staphylococci, streptococci, pneumococci, beta-hemolytic streptococci, viridans streptococci, Vibrio cholerae suis... Guizhi Fuling Pills
, typhoid and paratyphoid bacilli. It has an inhibitory effect; the alcohol extract of cinnamon twig also has an inhibitory effect on pneumococci, Escherichia coli, and Proteus. In addition to... More Chinese patent medicines for the treatment of Enterobacter pneumonia
Human body Surface area calculator, BMI index calculation and evaluation, female safe period calculator, due date calculator, normal weight gain during pregnancy, drug safety classification during pregnancy (FDA), five elements and eight characters, adult blood pressure evaluation, body temperature level evaluation, diabetes dietary recommendations, clinical biochemistry common units conversion, basal metabolic rate calculation supplement Sodium calculator, Iron supplement calculator, Commonly used Latin abbreviations for prescriptions, Quick check of commonly used pharmacokinetic symbols, Quick check of effective plasma osmolality calculator, Ethanol intake calculator
Medical encyclopedia, calculate now! Furazolidone Tablets, a drug related to Enterobacteriaceae pneumonia
It has certain antibacterial effects, including Salmonella, Shigella, Escherichia coli, Klebsiella pneumoniae, Enterobacter, Staphylococcus aureus, Enterococcus faecalis, and Suppura Sexual Streptococcus... Furazolidone Tablets
It has certain antibacterial effects, including Salmonella, Shigella, Escherichia coli, Klebsiella pneumoniae, Enterobacter, Staphylococcus aureus, Enterococcus faecalis, and S. pyogenes Sexual streptococci... Colistin sulfate tablets
Semi-synthetic penicillin will enhance the antibacterial effect of polymyxin against Escherichia coli, Enterobacter spp., Pseudomonas aeruginosa, etc. Drug overdose induces vomiting... Colistin sulfate tablets
Semi-synthetic penicillin will enhance the antibacterial effect of polymyxin against Escherichia coli, Enterobacter spp., Pseudomonas aeruginosa, etc.
Drug overdose induces vomiting...Chloramphenicol eye ointment