替加环素联合头孢哌酮/舒巴坦治疗泛耐药鲍氏不动杆菌的临床研究  

Clinic study on tigecycline and cefoperazone/sulbactam in the treatment of extend-drug resistant Acinetobacter baumannii infections

作　　者：史金英[1] 宋宁[1] 柴书坤[1] 李艳肖[1] 赵从会[1] 

机构地区：[1]石家庄市第一医院中心医院院区呼吸科,河北石家庄050011

出　　处：《中华医院感染学杂志》2015年第8期1750-1752,共3页Chinese Journal of Nosocomiology

基　　金：河北省医药卫生研究基金项目(20120449)

摘　　要：目的探讨替加环素联合头孢哌酮/舒巴坦对机械通气患者泛耐药鲍氏不动杆菌感染的临床疗效及病原菌清除的效果,为积极治疗泛耐药鲍氏不动杆菌感染提供临床经验。方法选择2012年1月-2013年3月医院呼吸科ICU泛耐药鲍氏不动杆菌感染患者15例,采用替加环素联合头孢哌酮/舒巴坦治疗,观察治疗前后患者临床资料及治愈率,所有数据采用SPSS 17.0软件进行统计分析。结果替加环素联合头孢哌酮/舒巴坦治疗后患者痰液由脓性黏稠转变为稀薄,胸片示斑片状影较治疗前明显吸收,体温、血白细胞、C-反应蛋白、氧合指数、血清白蛋白水平及APACHEⅡ评分均有明显好转,与治疗前相比差异有统计学意义(P<0.05);病原菌清除率为80.0%,临床治愈率为66.67%;15例患者中出现腹胀3例、腹泻2例,均未停止治疗,无其他不良反应发生。结论替加环素联合头孢哌酮/舒巴坦治疗泛耐药鲍氏不动杆菌疗效肯定,发生不良反应较少,是临床上较为理想的选择。OBJECTIVE To evaluate the microbiological eradication and clinical effectiveness of tigecycline and cefoperazone/sulbactam against extend-drug resistant Acinetobacter baumannii（XDRAB）infections in patients with mechanical ventilation,so as to provide clinical experience for clinical treatment of XDRAB infections.METHODS Totally 15 patients with XDRAB infections in respiratory ICU during Jan.2012 to Mar.2013 were enrolled and were treated with tigecycline and cefoperazone/sulbactam.The clinical data before and after treatment as well as the curative rate was observed.The software SPSS 17.0was used for statistical analysis of data.RESULTS After therapy with tigecycline and cefoperazone/sulbactam,sputum was turned from purulent sticky to thin,patchy shadows with X-ray signs were significantly absorbed than pre-therapy;temperature,leukocytes,CRP,PO2/FIO2,albumen,and Apache Ⅱ scores were significantly improved（P〈0.05）.The microbiological eradication rate was 80.00%and the curative rate was 66.67%.Three of 15 patients had abdominal distention,two diarrhea,all of which did not stop treatment.No other adverse reactions occurred.CONCLUSIONTigecycline and cefoperazone/sulbactam in the treatment of extend-drug resistant A.baumanniiinfections have positive clinical efficacy and few adverse reactions,which is an ideal clinical regimen.

关 键 词：替加环素 头孢哌酮/舒巴坦 多药耐药 鲍氏不动杆菌 

分 类 号：R978.1[医药卫生—药品]