基于替加环素的联合用药方案对多重耐药鲍曼不动杆菌所致呼吸机相关性肺炎的疗效分析（英文）

Tigecycline-based combination therapy for ventilator associated pneumonia due to multidrug-resistant Acinetobacter baumannii

目的:研究基于替加环素的联合用药方案对多重耐药鲍曼不动杆菌所致呼吸机相关性肺炎的治疗效果。方法:采用回顾性分析,对纳入研究的65例多重耐药鲍曼不动杆菌(MDRAB)所致呼吸机相关性肺炎(VAP)患者,根据是否使用替加环素分为替加环素组(38例)和非替加环素组(27例)。分析两组临床效果、微生物效果、治疗第7天感染指标[血浆降钙素原(PCT)浓度、白细胞(WBC)计数]、抗生素使用时间、ICU住院时间、医院住院时间以及14天病死率及院内病死率。结果:两组患者临床治疗效果、14天病死率、院内病死率(包括总病死率及归因于MRAB病死率),第7天感染指标、抗生素使用时间、ICU住院时间、医院住院时间等方面差异均无统计学意义(均P>0.05)。但在微生物治疗效果方面替加环素组清除率较非替加环素高(29/76.3%比12/44.4%,P=0.00),非替加环素组病原菌替换或多重感染率高(10/37.0%比4/10.5%,P=0.01)。结论:基于替加环素的联合用药方案对于MDRAB所致VAP疗效与其他联合用药方案无明显差异,但可显著提高细菌清除率。

Objective： To evaluate the effectiveness of tigecycline-based combination therapy for ventilator associated pneumonia due to multidrug-resistant Acinetobacter baumannii. Methods： This study was conducted by retrospective analysis,a total 65 patients with ventilator associated pneumonia caused by multidrug-resistant Acinetobacter baumannii were enrolled and classified into two groups,the tigecycline group（ 38 cases） and non-tigecycline group（ 27cases） depended on whether used tigecycline. Data collected from medical record including clinical outcomes,microbiological outcomes,laboratory data of infection（ White blood cell and Procalcitonin） on 7th day,duration of antibiotics use,length of Intensive care unit stay,length of hospital stay,14-day mortality and in-hospital mortality. Result： There were no statistical differences in clinical outcomes,infection index on 7th day,duration of antibiotics use,length of ICU stay,length of hospital stay,14-day mortality and In-hospital mortality. But as for the microbiological outcomes,tigecycline group has a higher microbiological eradication rate（ 29 /76. 3% vs. 12 /44. 4%,P = 0. 00）,whereas non-tigecycline group has a higher replacement or superinfection rate（ 10 /37. 0% vs. 4 /10. 5%,P = 0. 01）. Conclusion： Tigecycline-based combination therapy is comparable in clinical outcomes and with a favorable microbiological outcomes,when contrasted to other-based combination therapy.