碳青霉烯类抗生素联合舒巴坦治疗耐药鲍曼不动杆菌导致的医院获得性肺炎  

Treatment of hospital-acquired pneumonia induced by drug-resistant Acinetobacter baumannii with carbapenem and sulbactam

作　　者：王韧韬[1] 佘丹阳[1] 

机构地区：[1]解放军总医院呼吸内科,北京100853

出　　处：《军医进修学院学报》2011年第7期687-689,共3页Academic Journal of Pla Postgraduate Medical School

基　　金：解放军总医院苗圃基金项目(07MP13)

摘　　要：目的了解碳青霉烯类抗生素联合舒巴坦治疗碳青霉烯类耐药鲍曼不动杆菌导致的医院获得性肺炎的临床疗效。方法对2007年10月-2009年4月在我科确诊为对碳青霉烯类抗生素耐药鲍曼不动杆菌医院获得性肺炎(Hospital-Aquired Pneumonia,HAP)17例患者,采用碳青霉烯类抗生素联合舒巴坦治疗(亚胺培南西司他丁钠0.5g静滴1/6h或美洛培南0.5g静滴1/6h+舒巴坦1g静滴1/8h),记录患者发病时的临床特征及治疗终点的临床反应及30d病死率。结果 17例患者分离出的鲍曼不动杆菌菌株,全部对碳青霉烯类抗生素耐药,对环丙沙星、阿米卡星、米诺环素的耐药率分别为100%,94.1%,70.6%;碳青霉烯类抗生素联合舒巴坦治疗3日临床好转14例,治疗终点(End of Therapy,EOT)治愈好转11例,30d归因死亡3例。结论碳青霉烯类抗生素联合舒巴坦治疗策略的临床反应良好。Objective To observe the clinical effect of Carbapenems combined with sulbactam on hospital-acquired pheumonia（HAP） caused by carbapenem-resistant Acinetobacter baumannii. Methods Seventeen patients diagnosed with HAP caused carbapenemresistant Acinetobacter baumannii were treated with carbapenems combined with sulbactam（imipenem and cilastatiu sodium 0.5g iv （once 6h） or meropenem 0.5g iv （once 6h）combined with sulbactam lg iv （once 8h） in our hospital from October 2007 to April 2009. Their clinical features at onset of the disease, therapeutic reactions at the endpoint and 30-day mortality were recorded. Results The Acinetobacter baumannii strains isolated from the patients were resistant to carbapenems with a resistant rate to ciprofloxacin, amikacin and minocycline of 100%, 94.1%, and 70.6%, respectively. HAP was improved in 14 patients after 3-day treatment and in 11 patients at the end of treatment （EOT）. Three patients died of HAP after 30 days. Conclusion Carbapenems combined with sulbactam have a good therapeutic effect on HAP.

关 键 词：多耐药鲍曼不动杆菌 碳青霉烯 舒巴坦 临床特征 院内感染 

分 类 号：R563.11[医药卫生—呼吸系统]