替加环素治疗多或泛耐药鲍曼不动杆菌肺炎的疗效观察  

Clinical Experience with Tigecycline in the Treatment of Multi/extensively Drug-resistant Acinetobacter Baumannii Pneumonia

作　　者：谭建龙[1] 张卫东[1] 柳威[1] 刘志光[1] 李文朴[1] 江刚[1] 

机构地区：[1]湖南省人民医院呼吸内科,湖南长沙410005

出　　处：《中国呼吸与危重监护杂志》2013年第6期581-585,共5页Chinese Journal of Respiratory and Critical Care Medicine

摘　　要：目的探讨替加环素对多或泛耐药鲍曼不动杆菌肺炎的临床疗效。方法回顾性分析2012 年1 月至2013 年8 月因多或泛耐药鲍曼不动杆菌肺炎而使用替加环素治疗的26 例病例资料。观察患者的临床有效率、细菌清除率以及病死率。结果26 例患者使用替加环素, 其中2 例患者使用时间为2 d, 最终24 例纳入临床分析, 其中男18 例, 女6 例; 年龄24 ～81 岁, 平均（ 60. 08 ± 14. 52） 岁。7 例来自外科ICU,17 例来自于内科ICU。所有替加环素均联合给药。替加环素使用时间为3 ～16 d, 平均10 d。5 例患者在治疗期间死亡, 另5 例患者在30 d 内死亡, 30 d 总体病死率为 41. 67% 。12 例患者临床治疗有效, 有效率为50% ; 12 例治疗失败, 失败率为50%; 9 例获得细菌学清除, 细菌清除率为37. 5%。结论替加环素可尝试作为常规抗耐药鲍曼不动杆菌感染治疗方案失败后的抢救性治疗选择, 但尚需要更可靠的临床证据。Objective To evaluate the efficacy of tigecycline in patients with multi （ MDR） / extensively drug-resistant（ XDR） Acinetobacter baumannii pneumonia. Methods A retrospective analysis was conducted in adult patients with proven MDR/XDR A. baumannii pneumonia treated with tigecycline between January 2012 and August 2013. The clinical cure rates, microbiological eradication rates and mortality were measured. Results The study comprised a total of 24 MDR/XDR A. baumannii pneumonia cases （ 18 males） . Their mean age was （ 60. 08 ±14. 52） years （ ranged from24 to 81 years ） . 7 cases came from surgical ICUand 17 cases frommedical ICU. Tigecycline was combined with other antibiotics and used for a mean duration of 10 days（ range from3 to 16 days） . The 30-day overall mortality was 41. 67% . Clinical response were observed in 12 patients （ 50% ） while clinical failure was in 12 patients （ 50% ） . Microbiological eradication was achieved in 9 patients （ 37. 5% ） . Conclusion Tigecycline might be a salvage therapy option for patients who is non-responder to prior antimicrobial therapy but should be evaluated cautiously in prospective well-controlled studies.

关 键 词：替加环素 鲍曼不动杆菌 多耐药 泛耐药 肺炎 

分 类 号：R446.5[医药卫生—诊断学]