万古霉素治疗医院获得性耐甲氧西林金黄色葡萄球菌肺炎的临床评价

Clinical evaluation of vancomycin in the treatment of hospital-acquired methicillin-resistant Staphylococcus aureus pneumonia

目的评价万古霉素治疗医院获得性耐甲氧西林金黄色葡萄球菌(MRSA)肺炎的疗效及安全性。方法回顾性分析2011年1月—2014年4月应用万古霉素治疗的80例医院获得性MRSA肺炎患者临床资料,观察治疗前后患者临床症状、体征、实验室检查、细菌学检查及影像学检查变化,同时观察治疗中出现的不良反应。结果 80例MRSA肺炎患者治愈41例,显效19例,进步15例,无效5例,治疗总有效率75.0%(60/80);治疗后白细胞计数、降钙素原值明显下降,差异有统计学意义(P<0.01);MRSA清除率为82.5%;不良反应发生率为8.8%。结论万古霉素是治疗医院获得性MRSA肺炎有效、安全的药物。

Objective To evaluate the efficacy and safety of vancomycin in the treatment of hospital‐acquired methicillin‐resistant Staphylococcus aureus （HA‐MRSA） pneumonia .Methods A retrospective analysis was conducted with the clinical data of 80 patients with HA‐MRSA pneumonia treated with vancomycin during the period from January 2011 to April 2014 . The data for analysis included clinical symptoms and signs ,laboratory test results ,microbiology tests ,X‐ray findings ,and drug adverse reactions .Results The overall efficacy rate was 75 .0% （60/80） .Of the 80 cases ,41 were cured ,19 significantly improved ,15 improved ,and 5 failed .White blood cell count and serum procalcitonin decreased significantly after treatment with vancomycin （P〈 0 .01） .Overall ,82 .5% of the MRSA strains were eradicated .The overall incidence of drug‐related adverse reactions was 8 .8% .Conclusions Vancomycin is an effective and safe drug for HA‐MRSA pneumonia .