多黏菌素B治疗泛耐药肺炎克雷伯菌颅内感染疗效分析

Efficacy of polymyxin B in treating intracranial Klebsiella pneumoniae infection with pan-drug resistance

目的探讨多黏菌素B治疗泛耐药肺炎克雷伯菌颅内感染的临床疗效及愈后,为多黏菌素B在临床合理使用提供借鉴。方法采用回顾性分析方法,收集34例确诊泛耐药肺炎克雷伯菌颅内感染的病例资料,按药物治疗方案中是否使用多黏菌素分为两组,观察其脑脊液指标恢复情况、临床转归及肾功能指标。结果以多黏菌素B为基础,联合其他药物治疗泛耐药肺炎克雷伯菌颅内感染,能显著改善脑脊液指标、提高细菌清除率、延长生存时间,且无急性肾功能损伤出现,但是不能降低28d死亡率。多黏菌素使用方法采用静脉注射联合鞘内给药。结论以多黏菌素B为基础的联合用药治疗泛耐药肺炎克雷伯菌颅内感染有一定疗效,可用于治疗严重颅内感染。

Objective To investigate the clinical efficacy of polymyxin B in the treatment of intracranial Klebsiella pneumoniae infections with pan-drug resistance and its recovery and provide reference for the rational use of polymyxin B in clinical practice.Methods We used retrospective analysis and collected data from 34 cases of cranial infections with Klebsiella pneumoniae.The patients were divided into two groups depending on whether or not they were administered polymyxin,and the cerebrospinal fluid(CSF)index recovery,the clinical outcome and the renal function index were observed.Results Using polymyxin B combined with other drugs to treat cranial infections of Klebsiella pneumoniae can improve the CSF and bacterial clearance rate,prolong survival time,and cause no acute kidney injury,but can not reduce 28-day mortality.The method of administration of polymyxin was intravenous combined with intrathecal injection.Conclusion Polymyxin B showed some curative effects in the treatment of intracranial infection with K.pneumoniae with pan-drug resistance,and it can be used for the treatment of severe intracranial infections.