摘要
Objective:To investigate the infection of patients in the ICU with extensively drug-resistant Acinetobacter baumannii(XDRAB)and analyse the effect of tigecycline therapy for XDRAB.Methods:Seventy-one patients admitted to the ICU with XDRAB infection from January 2013 to July 2017 were divided into the tigecycline group(combination therapy with 50 mg tigecycline and 0.1 g minocycline every 12 hours)or the control group(no tigecycline treatment).Patient data,including age,sex,history of malignant tumour,body temperature,APACHE Ⅱ score,ALT,AST,GGT,TB,ALB,TBIL,DBIL,IBIL,BUN,Cr,absolute neutrophil count,procalcitonin(PCT),site positive for XDRAB infection,length of stay,and prognosis,were collected and compared between the two groups.Binary logistic regression was used to analyse the prognostic risk factors for XDRAB.Results:A total of 61.6% of the patients infected with XDRAB had multiple sites of XDRAB colonization.The cure rate achieved in the tigecycline group was higher than that of the control group(70.7%vs 41.9%).Multivariate analysis showed that older age,a high level of PCT after treatment and the absence of tigecycline treatment were poor prognostic factors for XDRAB infection.Conclusion:Combination therapy with tigecycline and minocycline is effective for XDRAB infection and reduces the cost of treatment.Combined therapy with tigecycline is a predictor of good prognosis for patients infected with XDRAB,whereas older age and increased PCT levels after treatment are predictors of poor prognosis.
