替加环素治疗多重耐药菌肺部感染的临床观察

Clinical observation of tigecycline in treatment of pulmonary infections caused by multi-drug resistant bacteria

目的探讨替加环素治疗多重耐药菌肺部感染的临床疗效。方法回顾性分析2014年4月至2015年4月我院应用替加环素治疗多重耐药菌肺部感染患者的临床有效率、细菌清除率、不良反应发生率。结果治疗前及治疗后不同时段白细胞、C-反应蛋白、血清降钙素比较有差异(P<0.05);临床有效率为72.2%,细菌清除率为61.1%,不良反应发生率为5.6%。其中多重耐药鲍曼不动杆菌的有效率为70%,嗜麦芽窄食单胞菌为80%,耐甲氧西林金葡菌为66.7%,耐碳氢酶烯肠杆菌属为66.7%,耐万古霉素屎肠球菌为100%;两药和多药联合的临床有效率明显高于单药治疗(P<0.05),两药联合和多药联合相比无差异(P>0.05)。结论替加环素治疗多重耐药菌肺部感染的临床疗效显著且不良反应少,但应联合用药。

Objective To evaluate the clinical efficacy of tigecycline in treatment of multi-drug resistant pul-monary infections. Methods The clinical efficiency, bacterial clearance and incidence of adverse reactions of tige-cycline in treatment of pneumonic patients with multi-resistant bacteria from April 2014 to April 2015 were analyzed retrospectively. Results The difference of white blood cell, C-reactive protein and procalcitonin were significant be-fore and after treatment. The clinical effective rate was 72. 2%, the bacterial clearance rate was 61. 1%, and the in-cidence of adverse reactions was 5. 6%. The clinical effective rate of multi-drug resistant acinetobacter baumannii, Maltophilia Aeromonas, Methicillin-resistant Staphylococcus aureus, Carbapenem-resistant Enterobacter and Vanco-mycin-resistant Enterococcus feces were 70%, 80%, 66. 7%, 66. 7% and 100%. The clinical effective rate of the bivalent and multi-linked group were significantly higher than the alone group. However, it was similar between the bivalent and multi-linked group. Conclusion Tigecycline has a significant treatment effect and a low incidence of adverse reactions on multi-drug resistant pulmonary infections, but it should be combined with other antibacterials.