替加环素治疗呼吸机相关性肺炎患者泛耐药鲍氏不动杆菌感染的临床研究

发布时间：2018-03-25 00:24

本文选题：替加环素　切入点：泛耐药　出处：《中华医院感染学杂志》2016年06期

【摘要】：目的探讨替加环素治疗重症呼吸机相关性肺炎患者泛耐药鲍氏不动杆菌感染的临床疗效。方法对2012年7月-2014年3月16例高龄患者确诊发生泛耐药鲍氏不动杆菌重症呼吸机相关性肺炎,给予替加环素首剂100mg,之后每次50mg,静脉滴注12h1次;同时联合舒巴坦或碳青霉烯类或单独用药,治疗时间为10~14d;监测治疗期间所有患者的症状、体征,定期检测血常规、肝肾功能、胸部X线片及痰液培养及药物不良反应。结果 16例患者4例死亡、5例痊愈、7例有效,总有效率75.0%;16例患者10例细菌培养显示清除、6例未清除;5例痊愈及7例有效,患者影像学有明显改善,死亡患者影像学呈加重、恶化;3例患者出现轻度肝功能损害,经积极护肝治疗后痊愈。结论替加环素单独或联合用药治疗泛耐药鲍氏不动杆菌感染重症呼吸机相关性肺炎疗效明确,安全。
[Abstract]:Objective to investigate the clinical efficacy of tegicycline in the treatment of pan-drug-resistant Acinetobacter baumannii infection in patients with severe ventilator-associated pneumonia. Methods from July 2012 to March 2014, 16 elderly patients were diagnosed to have Pan-resistant Acinetobacter baumannii. Ventilator-associated pneumonia, The first dose of tegicycline was 100 mg, then 50 mg each time, 12h1 was given intravenously, and combined with sulbactam or carbapenem alone for 10 ~ 14 days, the symptoms and signs of all patients during the treatment were monitored, and blood routine examination, liver and kidney function were regularly detected. Results among the 16 patients, 4 cases died and 5 cases were cured and 7 cases were effective. The total effective rate was 75.0%. The total effective rate was 75.0%. 10 cases of bacterial culture showed that 6 cases were cured and 7 cases were cured, 6 cases were not cleared, 5 cases were cured and 7 cases were effective. The imaging of the patients was improved obviously, the imaging of the dead patients was aggravated, and the mild liver function damage was found in 3 patients with exacerbation. Conclusion tegicycline alone or in combination is effective and safe in the treatment of severe ventilator-associated pneumonia with pan-drug-resistant Acinetobacter baumannii infection.
【作者单位】：嘉兴学院附属第二医院ICU;嘉兴学院附属第二医院心内科;嘉兴学院附属第二医院医院感科;
【基金】：国家卫计委医院感染预防与控制能力建设基金资助项目(CHA-2012-XSPX-0629-1)
【分类号】：R446.5

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