多黏菌素B治疗泛耐药鲍曼不动杆菌感染的临床分析  

Clinical Analysis of Polymyxin B in the Treatment of Pan-drug Resistant Acinetobacter Baumannii Infection

作　　者：叶冰[1] 翁钦永[1] 陈影[1] 邹志强[1] YE Bing;WENG Qinyong;CHEN Ying;ZOU Zhiqiang(Department of Critical Care Medicine, Fujian Medical University Union Hospital, Fuzhou 350001, China)

机构地区：[1]福建医科大学附属协和医院重症医学科

出　　处：《福建医科大学学报》2019年第6期405-408,共4页Journal of Fujian Medical University

摘　　要：目的探讨以多黏菌素B为基础的抗感染方案治疗泛耐药鲍曼不动杆菌(简称“AB”)感染的临床用法及疗效。方法回顾性分析2018年1月-2019年5月收治的泛耐药AB感染者60例的临床资料。分别根据多黏菌素B的用药时间及联合药物的不同进行分组,比较各组间的细菌清除率和治疗总有效率。结果(1)60例患者均予多黏菌素B为基础的抗感染方案,细菌清除率达58.3%,总治疗有效率达51.6%;(2)用药时间≥7 d细菌清除率及治疗总有效率均高于用药时间<7 d(P<0.05);(3)多黏菌素B联合替加环素组、多黏菌素B联合头孢哌酮-舒巴坦组及多黏菌素B联合米诺环素组3组在细菌清除率及治疗总有效率比较,差别均无统计学意义(P>0.05)。结论足量的给药疗程能提高多黏菌素B治疗泛耐药AB的细菌清除率及临床治疗有效率。尽管菌株对碳青霉烯类、头孢哌酮舒巴坦或米诺环素耐药,但上述药物仍能作为在泛耐药AB感染治疗上多黏菌素B联合用药的选择。Objective This study was aimed to investigate the clinical use and efficacy of polymyxin B-based anti-infection regimen in the treatment of pan-drug resistant Acinetobacter baumannii infection.Methods The data of 60 patients with pan-drug resistant Acinetobacter baumannii infection in ICU from January 2018 to May 2019 were analyzed retrospectively.The bacterial clearance rate,and clinical efficiency rate were compared among groups according to the time of polymyxin B administration and the different combination drugs.Results(1)All 60 patients were given polymyxin B-based anti-infective regimen.The bacterial clearance rate was 58.3%,and the clinical efficiency rate was 51.6%.(2)The bacterial clearance rate and the clinical efficiency rate of patients with treatment time over 7 days were higher than the rest ones(P<0.05).(3)There was no significant difference in bacterial clearance rate and clinical efficiency rate among the three groups(P>0.05),which were polymyxin B combined with tegacycline group,polymyxin B combined with cefoperazone-sulbactam group and polymyxin B combined with minocycline group(P>0.05).Conclusions Adequate course of treatment can improve bacterial clearance rate and clinical treatment efficiency.Although the strains are resistant to carbapenems,cefoperazone sulbactam or minocycline,the above drugs can still be used as a combination of polymyxin B in the treatment of pan-drug resistant Acinetobacter baumannii infection.

关 键 词：多黏菌素B 药物疗法 联合 鲍氏不动杆菌 药物耐受性 细菌/代谢 

分 类 号：R320.99[医药卫生—人体解剖和组织胚胎学] R37[医药卫生—基础医学]