替加环素治疗泛耐药鲍曼不动杆菌医院获得性肺炎的临床疗效及不良反应

发布时间：2018-04-14 08:57

本文选题：替加环素 + 泛耐药鲍曼不动杆菌　；参考：《中国感染控制杂志》2016年02期

【摘要】：目的观察替加环素对泛耐药鲍曼不动杆菌(XDRAB)医院获得性肺炎(HAP)的临床疗效及不良反应。方法对2013年3月—2014年6月某院重症监护病房(ICU)发生XDRAB HAP并使用替加环素治疗的患者临床资料进行回顾性分析。结果 31例HAP患者痰分离的XDRAB对替加环素均敏感,对碳青霉烯类及舒巴坦类抗生素,包括头孢哌酮/舒巴坦(SCF),耐药率为100%,其中混合感染患者17例(54.84%)。替加环素联用SCF使用率:呼吸ICU组为85.71%(12/14),中心ICU组为47.06%(8/17)。31例患者,临床痊愈率为29.03%、有效率为45.16%,细菌清除率为61.29%,药物不良反应率为16.13%,无严重药物不良反应发生。呼吸ICU组与中心ICU组痊愈率分别为42.86%、17.65%,有效率分别为71.43%、23.53%,细菌清除率分别为78.57%、47.06%,两组临床有效率比较,差异具有统计学意义(P0.05)。替加环素联用SCF组与非联用SCF组痊愈率分别为35.00%、18.18%,有效率为60.00%、18.18%,细菌清除率为65.00%、54.55%,两组临床有效率比较,差异具有统计学意义(P0.05)。结论替加环素对XDRAB HAP具有良好的临床疗效,药物不良反应少;联合SCF是一个值得推广的选择。
[Abstract]:Objective To observe the effect of tigecycline against pan drug resistant Acinetobacter Bauman (XDRAB) of hospital acquired pneumonia (HAP) the clinical efficacy and adverse reactions. Methods from March 2013 to June 2014 in a hospital intensive care unit (ICU) of XDRAB HAP and the use of additional ring for patients in treatment of clinical data were retrospectively analyzed. Results 31 cases of sputum in patients with isolated XDRAB HAP of tigecycline were sensitive to carbapenems and sulbactam antibiotics, including Cefoperazone / Shubatan (SCF), the drug resistance rate was 100%, of which 17 cases of patients with mixed infection (54.84%). Tigecycline combined with SCF group ICU: respiratory rate 85.71% (12/14), ICU group was 47.06% (8/17).31 patients, the clinical cure rate is 29.03%, effective rate was 45.16%, the bacterial clearance rate was 61.29%, the rate of adverse reaction was 16.13%, no serious adverse reaction occurred. ICU group and ICU group respiratory center recovery rate were 42.86%, 17 .65%, the efficiency were 71.43%, 23.53%, the bacterial clearance rates were 78.57%, 47.06%, two groups of clinical efficiency comparison, the difference was statistically significant (P0.05). Tigecycline combined with SCF group and non SCF group combined with recovery rate were 35%, 18.18%, effective rate was 60%, 18.18%, bacteria the clearance rate was 65%, 54.55%, two groups of clinical efficiency comparison, the difference was statistically significant (P0.05). Conclusion tigecycline has good clinical effect on XDRAB HAP, less adverse drug reactions; combined with SCF is a worthy choice.

【作者单位】：中南大学湘雅二医院湖南省呼吸疾病诊疗中心中南大学呼吸疾病研究所;
【基金】：国家自然科学基金(81370164) 湖南省自然科学基金(2015JJ4087) 国家临床重点专科建设项目
【分类号】：R446.5

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