摘要
目的研究替加环素联合头孢哌酮/舒巴坦钠(CS)及碳青霉烯类抗菌药物(美罗培南、亚胺培南西司他丁钠、比阿培南)治疗成人耐碳青霉烯鲍氏不动杆菌(CRAB)肺部感染的临床疗效和安全性。方法选取2019年12月-2023年1月山西省人民医院以替加环素为基础联合CS(T+CS组,43例)或碳青霉烯类药物(T+C组,47例)治疗的CRAB肺部感染患者为研究对象,比较两组患者的临床资料和临床结局。Kaplan-Meier法评估两治疗组患者生存曲线的差异。结果两组患者临床基本资料相似,年龄、性别、基础疾病、合并感染情况、实验室检查数据等比较均无统计学差异;T+C组患者相比于T+CS组的患者接受肠内营养和发生感染性休克的例数更多(P<0.05):T+C组比T+CS组患者30 d病死率和微生物清除失败率高(P<0.05);Log-Rank检验结果提示两组患者的生存曲线有统计学差异(P<0.05)。结论对于CRAB肺部感染患者,替加环素联合头孢哌酮/舒巴坦钠相较于联合碳青霉烯类药物可能是一种更有价值的治疗方案。
OBJECTIVE To observe the clinical effects of tigecycline combined with cefoperazone-sulbactam(CS)and carbapenems(meropenem,imipenem cilastatin sodium and biapenem)on treatment of the patients with car-bapenem-resistant Acinetobacter baumannii(CRAB)pulmonary infection and analyze the safety.METHODS The patients with CRAB pulmonary infection who were given tigecycline combined with CS(the T+CS group,43 ca-ses)and tigecycline combined with carbapenems(the T+C group,47 cases)were recruited as the research sub-jects.The clinical data and clinical outcomes were observed and compared between the two groups of patients.The difference in survival curve between the two groups was assessed by Kaplan-Meier method.RESULTS The baseline clinical data of the two groups were similar.There were no significant differences in age,gender,under-lying disease,status of complication with infection and laboratory test indexes between the two groups.The num-ber of the patients who received enteral nutrition therapy and had septic shock was larger in the T+C group than in the T+CS group(P<0.05).The 30-day mortality rate and the failed rate of eradication of microorganisms of the T+C group were higher than those of the T+CS group(P<0.05).The result of Log-Rank test indicated that there was significant difference in the survival curve between the two groups of patients(P<0.05).CONCLUSION Tigecycline combined with cefoperazone-sulbactam is more valuable than the combination with carbapenems for treatment of the patients with CRAB pulmonary infection.
作者
任俊丽
彭芳辰
周煊平
鲁汝淇
郑斌
REN Jun-li;PENG Fang-chen;ZHOU Xuan-ping;LU Ru-qi;ZHENG Bin(Shanri Medical University,Taiyuan,Shanri 030001,China;不详)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2024年第1期18-22,共5页
Chinese Journal of Nosocomiology
基金
中国医药教育协会“聚火优才”全国药学服务重大科研项目(CMEAPC2023002)
山西省卫生健康委科研课题计划项目(2022157)。
