不同抗菌药物对ICU泛耐药鲍氏不动杆菌感染的临床疗效对比分析

发布时间：2019-02-15 20:51

【摘要】：目的研究ICU泛耐药鲍氏不动杆菌(PDRAB)感染应用不同抗菌药物治疗的临床效果,为临床治疗提供理论依据。方法选择2013年6月-2015年6月医院ICU诊治的40例发生PDRAB感染患者,40例PDRAB感染患者均应用头孢哌酮/舒巴坦进行治疗,其中18例患者应用大剂量药物进行单独治疗,每天9~12g,22例患者联合左氧氟沙星或者米诺环素进行治疗,疗程(13.3±5.3)d;有10例患者经治疗后效果不佳改为多黏菌素E单独进行治疗,疗程(16.9±5.0)d;分析PDRAB感染患者临床特点、抗菌药物的选择以及临床治疗效果。结果 40例患者通过深静脉导管、血液、脓液、支气管灌洗液、胆汁、引流液以及创面等标本中检测出40株PDRAB,其中有18例为多部位感染;40例PDRAB感染患者经治疗后,临床总有效率40.0%、细菌清除率32.5%及病死率为22.5%。结论 PDRAB感染患者采用大剂量头孢哌酮/舒巴坦或者联合米诺环素治疗的临床效果显著,是首选的国内治疗PDRAB的一种方法,PDRAB感染采用多黏菌素E治疗的临床效果也较好,能够将其列为治疗PDRAB感染的有效治疗方法中。
[Abstract]:Objective to study the clinical effect of ICU pan-resistant Acinetobacter baumannii (PDRAB) infection with different antimicrobial agents and to provide theoretical basis for clinical treatment. Methods from June 2013 to June 2015, 40 patients with PDRAB were treated with cefoperazone / sulbactam, and 18 patients were treated with large dose of drugs, 912g / day, respectively, and 40 patients with PDRAB were treated with cefoperazone / sulbactam. 22 patients were treated with levofloxacin or minocycline for (13.3 卤5.3) days. After treatment, 10 patients were treated with polymyxin E alone for (16.9 卤5.0) days. The clinical characteristics of patients with PDRAB infection, the choice of antimicrobial agents and the effect of clinical treatment were analyzed. Results 40 strains of PDRAB, were detected by deep venous catheter, blood, pus, bronchial lavage fluid, bile, drainage fluid and wound. After treatment, the total effective rate of 40 patients with PDRAB infection was 40.0%, the bacterial clearance rate was 32.5% and the mortality rate was 22.5%. Conclusion High dose of cefoperazone / sulbactam or minocycline combined with minocycline is the first choice for the treatment of PDRAB in patients with PDRAB infection. The clinical effect of PDRAB infection treated with polymyxin E is also good. It can be included in the effective treatment of PDRAB infection.
【作者单位】：滨州市人民医院药学部;滨州市人民医院骨三科;滨州市人民医院普外科;滨州市人民医院儿一科;
【基金】：山东省自然科学基金资助项目(2014ZRB14421)
【分类号】：R446.5

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