NICU患者替加环素联合治疗多药耐药菌感染的临床研究  

Clinical efficacy of tigecycline combination therapy in treatment of multidrug-resistant bacteria infections in NICU patients

作　　者：余敏[1] 王勤鹰[1] 顾勤[1] 王星[1] 邓冰[1] 姜嘟嘟[1] 赵丽娟[1] 詹青[1] 

机构地区：[1]同济大学附属同济医院NICU,上海200065

出　　处：《中华医院感染学杂志》2014年第24期6086-6088,共3页Chinese Journal of Nosocomiology

基　　金：上海市科委医学引导基金资助项目(114119a5800)

摘　　要：目的观察分析神经重症监护病房(NICU)多药耐药菌(MDRB)感染患者应用替加环素联合其他抗菌药物治疗的临床疗效,探讨其治疗价值。方法收集2012年7月-2013年12月NICU 9例多药耐药菌感染患者应用替加环素联合其他抗菌药物治疗临床资料,对气管插管/切开率呼吸机相关性肺炎(VAP)发生率、多药耐药菌分布、细菌学疗效、临床疗效及联合治疗过程中不良反应进行统计分析。结果 9例患者中气管插管/切开及使用呼吸机6例,发生VAP4例,发生率66.7%;检出多药耐药菌共10株,8株为多药耐药肺炎克雷伯菌、2株多药耐药鲍氏不动杆菌,有2例患者合并感染金黄色葡萄球菌,1例同时感染多药耐药肺炎克雷伯菌及鲍氏不动杆菌;临床治疗有效率66.7%,多药耐药菌清除率为22.2%;不良反应以腹泻最多见。结论合理使用替加环素联合治疗多药耐药菌,有利于提高神经重症感染患者的生存率。OBJECTIVE To observe the clinical efficacy of tigecycline combined with other antibiotics in treatment of multidrug‐resistant bacteria infections in the patients of neurosurgery intensive care unit （NICU ） and explore the therapeutic effect .METHODS The clinical data were collected from 9 patients with multidrug‐resistant bacteria in‐fections who were treated with tigecycline combined with other antibiotics from Jul 2012 to Dec 2013 ;the rate of endotracheal intubation/incision ,incidence of ventilator‐associated pneumonia （VAP） ,distribution of multidrug‐resistant bacteria ,bacteriologic efficacy ,clinical efficacy ,and adverse reactions during the combination therapy were statistically analyzed .RESULTS Among the 9 patients ,6 cases underwent the endotracheal intubation/inci‐sion and used ventilator ,among whom VAP occurred in 4 cases with the incidence rate of 66 .7% .A total of 10 strains of multidrug‐resistant bacteria have been isolated , including 8 strains of multidrug‐resistant K lebsiella pneumoniae and 2 strains of multidrug‐resistant Acinetobacter baumannii ;there were 2 patients with concurrent Staphylococcus aureus infection and 1 patient with concurrent multidrug‐resistant K .pneumoniae and A .bauman‐nii infections .The effective rate of clinical treatment was 66 .7% ,the clearance rate of the multidrug‐resistant bacteria was 22 .2% .The diarrhea was the most common adverse reaction .CONCLUSION For the treatment of multidrug‐resistant bacteria infections ,the reasonable tigecycline combination therapy may raise the survival rate of the patients with severe infections in NICU .

关 键 词：神经重症监护病房 多药耐药菌 替加环素 临床疗效 细菌学疗效 不良反应 

分 类 号：R978.1[医药卫生—药品]