磷霉素治疗耐碳青酶烯-肺炎克雷伯菌感染的疗效观察  

The efficacy of fosfomycin for the treatment of nosocomial infections caused by carbapenem-resistant klebsiella pneumoniae

作　　者：李林[1,2] 张晓芬[1,2] 曾友志[1,2] 张建[1,3] 曹海泉[1,4] 

机构地区：[1]川北医学院第二临床医学院 [2]南充市中心医院临床药学科,四川南充637000 [3]南充市中心医院检验科,四川南充637000 [4]南充市中心医院ICU室,四川南充637000

出　　处：《西部医学》2015年第4期611-613,共3页Medical Journal of West China

基　　金：南充市应用技术研究与开发项目(11A0110)

摘　　要：目的评价磷霉素治疗ICU医院获得性感染危重患者耐碳青酶烯类-肺炎克雷伯菌(CRKP)的安全性和有效性。方法对诊断为ICU医院获得性CRKP,经临床药师会诊建议采用静脉磷霉素治疗的患者11例,经中心静脉导管滴注磷霉素钠,根据药敏结果联用敏感抗菌药物,以病死率为主要结局指标,以临床疗效、细菌学疗效、不良事件发生率为次要结局指标。结果 11例患者均取得细菌微生物清除或假定清除,临床疗效评价为临床治愈。有2例患者死亡,病死率为18.2%,无患者因CRKP导致感染复发。所有患者均能耐受磷霉素,没有发现肝或肾功能检查异常。结论磷霉素可能成为成人患者CRKP感染治疗的一种选择,特别是联用其他抗菌药物时可获得更好的临床疗效。Objective To evaluate the safety and efficacy of fosfomycin for the treatment of nosocomial infection caused by Carbapenem-resistant Klebsiella Pneumoniae （CRKP） in critically ill patients in the ICU. Methods Adult ICU patients who received intravenous fosfomycin were prospectively examined to assess its safety and effectiveness as an adjunct to the antimicrobial therapy of life-threatening infections caused by carbapenem-resistant Klebsiella pneumoniae. Fosfomycin was administered intravenously in 11 patients for treatment of hospital-acquired infections caused by carbapenem-resistant K. pneumoniae. Fosfomycin （2-4 g every 6 h） was administered in combination with other antibiotics. Results All patients had good bacteriological and clinical outcome of infection. A total of 2 patients died, mortality was 18.2%, but no patients caused by CRKP infection case was recurred. All patients tolerated fosfomycin, found no abnormal hepatic or renal function. Conclusion Fosfomycin may be a new options for the treatment of adult CRKP infection, especially with other antibiotics.

关 键 词：磷霉素 耐碳青酶烯-肺炎克雷伯菌 重症监护病房 多重耐药菌 医院获得性感染 临床药师 

分 类 号：R969.3[医药卫生—药理学]