某院鲍曼不动杆菌血流感染治疗方案的制定  

Development of regimens against bloodstream infections due to Acinetobacter baumannii in a hospital

作　　者：李彦萍[1] 马晓波[2] 杭永付[3] 孙洲亮[1] LI Yan-ping;MA Xiao-bo;HANG Yong-fu;SUN Zhou-liang(Pharmacy Department, First Affiliated Hospi tal of Xiamen University,Fujian Xiamen 361000, China;Laboratory Department, First Affiliated Hospital of Xiamen Univer- sity,Fujian Xiamen 361000, China;Pharmacy Department, First Affiliated Hospital of Soochow University, Jiangsu Suzhou 215006, China)

机构地区：[1]厦门大学附属第一医院药学部,福建厦门361000 [2]厦门大学附属第一医院检验科,福建厦门361000 [3]苏州大学附属第一医院药学部,江苏苏州215006

出　　处：《中国医院药学杂志》2018年第10期1084-1086,共3页Chinese Journal of Hospital Pharmacy

摘　　要：目的:制定某院鲍曼不动杆菌血流感染的治疗方案。方法:收集某院2015-2016年血标本培养出的鲍曼不动杆菌39株,测定对氨苄西林舒巴坦,替加环素,亚胺培南,美罗培南的最低抑菌浓度。运用蒙特卡洛方法计算不同方案的达标概率(PTA)和累积反应分数(CFR)。结果:氨苄西林舒巴坦3 g q6h对鲍曼不动杆菌的CFR为66.05%,替加环素50 mg q12h,100mg q12h的CFR分别为95.75%和99.77%,亚胺培南1 g q8h,q6h和美罗培南1 g q8h,q6h的CFR分别是67.74%,96.56%和74.19%,88.8%。结论:某院鲍曼不动杆菌血流感染时,经验选择可用替加环素50 mg q12h,100 mg q12h和亚胺培南1 g q6h方案。目标治疗应根据最低抑菌浓度(MIC)情况选择方案。OBJECTIVE To develop therapeutic regimens against bloodstream infections due to Acinetobacter baumannii（ABA）in a hospital.METHODS Totally 39 strains of ABA from blood culture were collected from 2015 to 2016 in a hospital.MICs were measured for ampicillin sulbactam（SAM）,tigecycline（TGC）,imipenem（IPM）and meropenem（MEM）against ABA.PTA and CFR of different regimens against ABA were calculated.RESULTS CFR was 66.05%for SAM3g q6h regimen against ABA,95.75% and 99.77% for TGC50 mg q12h and 100 mg q12h,67.74%,96.56% and 74.19%,88.8% for IMP1 g q8 h,q6 h and MEM1g q8h,q6h,respectively.CONCLUSION For bloodstream infection due to ABA,TGC50 mg,100 mg q12h and IMP1g q6h regimens can be chosen.For target therapy,combination therapy should be considered against MIC≥16μg·mL-1.

关 键 词：鲍曼不动杆菌 血流感染 替加环素 蒙特卡洛模拟 

分 类 号：R969[医药卫生—药理学]