21例泛耐药鲍氏不动杆菌肺炎治疗分析

Therapeutic analysis of pan-drug resistant acinetobacter baumannii causing pneumonia in 21 patients

目的探讨较大剂量头孢哌酮/舒巴坦治疗泛耐药鲍氏不动杆菌肺炎的临床疗效,为临床合理应用抗菌药物提供指导。方法对2009年5月-2010年7月21例使用头孢哌酮/舒巴坦治疗泛耐药鲍氏不动杆菌肺炎的危重症患者进行回顾分析,对头孢哌酮/舒巴坦的临床疗效进行观察。结果 21例患者经治疗后,其中7例治愈,6例改善,8例失败,总有效率61.9%;8例患者细菌得到有效清除,细菌清除率为38.1%,3例患者死亡。结论较大剂量头孢哌酮/舒巴坦治疗泛耐药鲍氏不动杆菌肺炎,取得较满意疗效;细菌清除率低,与临床疗效相关性差,考虑与细菌定植有关。

OBJECTIVE To investigate the clinical therapeutic effect of mid-large dose cefoperazone/sulbactam to pan-drug resistant（PDR） Acinetobacter baumannii pneumonia and provide experience for proper choice of antibiotics in clinic.METHODS A retrospective study was conducted to define the patients who received cefoperazone/sulbactam for PDR A.baumannii pneumonias between May,2009 and July,2010.A total of 21 severe patients were eligible for the study.The clinical therapeutic effect of cefoperazone/sulbactam was observed.RESULTS Thirteen out of 21 patients had successful clinical outcomes,cure in 7 patients and improvement in 6.The total effective rate was 61.9%.Eight of 21 patients had microbiological success,the microbiological clearance rate was 38.1%.Three of 21 patients died.CONCLUSIONS The clinical therapeutic effect of mid-large dose cefoperazone/sulbactam to PDR A.baumannii pneumonia is encouraging.The microbiological clearance rate is poor.Correlation between microbiological response and clinical outcome is poor and related to the microbiological colorizations.