替加环素治疗碳青霉烯类耐药革兰阴性菌医院获得性肺炎的临床研究

Clinical study on tigecycline therapy for nosocomial pneumonia due to carbapenem-resistant gram-negative bacteria

目的研究替加环素(TGC)对碳青霉烯类耐药革兰阴性菌(CRGNB)所致重症医院获得性肺炎(HAP)、呼吸机相关性肺炎(VAP)的临床疗效,为临床治疗提供参考依据。方法回顾分析2013年1月-2015年12月医院呼吸HAP/VAP患者,其中TGC治疗33例为治疗组,18例为对照组;分析其临床及微生物学资料、治疗情况等。结果治疗组有效率、清除率、ICU病死率与对照组比较,差异有统计学意义(P<0.05);抗菌药物使用时间、机械通气时间、ICU住院时间、及治疗后30d全因病死率两组比较差异无统计学意义。结论对于入住ICU的CRGNB所致HAP/VAP患者,TGC联合抗感染治疗是为数不多的可供选择的有效治疗方法之一。

OBJECTIVE To examine the effect of tigecycline（TGC）on hospital-acquired pneumonia（HAP）and ventilator-associated pneumonia（VAP）due to carbapenem-resistant gram-negative bacteria（CRGNB）in critically patients,so as to provide reference for clinical treatment.METHODS A retrospective study was conducted in HAP/VAP patients from Jan.2013,to Dec.2015,among which the 33 patients with TGC treatment were in treatment group,and 18 patients were in control group.Clinical status,microbiological outcomes and treatment were under analysis.RESULTS There were significant differences between treatment group and control group in clinical cure rate microbiological eradicated rate,ICU mortality（P〈0.05）.There was no difference at the duration of antibiotic treatment,duration of mechanical ventilation,ICU length of stay,and 30 day all-cause mortality between the two groups.CONCLUSIONTGC combined antibiotic therapy might be a justifiable option for critically patients in ICU with HAP/VAP due to CRGNB,when there are limited options for these patients.