不同抗生素联合替加环素治疗MDRAB相关VAP患者效果比较  

Effect of different antibiotics combined with tigecycline in patients with multidrug-resistant Acinetobacter baumannii-related ventilator-associated pneumonia:A comparative study

作　　者：石新艳[1] 尚宁 王虹[3] 杨婷婷[4] 赵春玲[5] 齐卫卫[6] 刘伟[1] SHI Xinyan;SHANG Ning;WANG Hong;YANG Tingting;ZHAO Chunling;QI Weiwei;LIU Wei(Office of Party Affairs and Administration,Laoshan Campus,The Affiliated Hospital of Qingdao University,Qingdao 266075,China)

机构地区：[1]青岛大学附属医院崂山院区党政办公室,山东青岛266075 [2]青岛市妇女儿童医院 [3]青岛市市立医院医院感染管理科 [4]青岛大学附属医院护理院感处 [5]青岛大学附属医院医保与收费管理处 [6]青岛大学附属医院肿瘤科

出　　处：《精准医学杂志》2024年第5期431-434,共4页Journal of Precision Medicine

基　　金：国家自然科学基金项目(81602068)。

摘　　要：目的探讨不同抗菌药物联合替加环素治疗多重耐药鲍曼不动杆菌(MDRAB)相关呼吸机相关性肺炎(ventilator associated pneumonia,VAP)患者的效果,旨在为临床上更好治疗该病提供方案选择。方法收集2016年1月—2023年8月青岛市市立医院收治的MDRAB相关VAP患者的临床资料,根据治疗方案不同分为替加环素组(A组)56例,头孢哌酮舒巴坦联合治疗组(B组)42例,碳青霉烯类联合治疗组(C组)24例,对三组患者住院期间感染情况及各项疗效指标进行比较。结果三组MDRAB相关VAP感染患者间感染病原体的种类、合并感染部位比较差异均无显著性(P>0.05),B组和C组细菌清除率高于A组(χ^(2)=5.38、4.48,P<0.05),三组患者住院病死率比较差异无显著性(P>0.05)。结论替加环素联合头孢哌酮舒巴坦或碳青酶烯类抗菌药物治疗MDRAB相关VAP的细菌清除率均显著高于单独使用替加环素,联合用药是一种比较好的治疗选择。Objective To investigate the effect of different antibacterial agents combined with tigecycline in patients with multidrug-resistant Acinetobacter baumannii(MDRAB)-related ventilator-associated pneumonia(VAP),and to provide options for better treatment of the disease in clinical practice.Methods A retrospective analysis was performed for the clinical data of the patients with MDRAB-related VAP who were admitted from January 2016 to August 2023 in Qingdao municipal Hospital,and according to the treatment regimen,they were divided into tigecycline group(group A)with 56 patients,cefoperazone-sulbactam combination therapy group(B group)with 42 patients,and carbapenem combination therapy group(group C)with 24 patients.The three groups were compared in terms of infection and related outcome measures.Results There were no significant diffe-rences in the type of pathogene infected and infection sites between the three groups(P>0.05).Groups B and C had a significantly higher bacterial clearance rate than group A(χ^(2)=5.38,4.48,P<0.05),and there was no significant difference in in-hospital mortality rate between the three groups(P>0.05).Conclusion Tigecycline combined with cefoperazone-sulbactam or carbapenem achieves a higher bacterial clearance rate than tigecycline alone in MDRAB-related VAP,and combined medication is a relatively good treatment option.

关 键 词：替加环素 肺炎 呼吸机相关性 鲍氏不动杆菌 抗药性 细菌 疗效比较研究 

分 类 号：R563.19[医药卫生—呼吸系统]