Objective:To explore the effects of bronchoscopy alveolar lavage in the treatment of severe pneumonia caused by multiple drug bacterial infection.Methods:A total of 84 patients with severe pneumonia infected by multi-...Objective:To explore the effects of bronchoscopy alveolar lavage in the treatment of severe pneumonia caused by multiple drug bacterial infection.Methods:A total of 84 patients with severe pneumonia infected by multi-drug resistant bacteria were randomly selected from Kunming Second People's Hospital,which is our hospital from January 2019 to December 2020 for this research.They were divided into a reference group and a study group using a digital table method,with 42 cases in each group.The reference group was given the routine treatment,the research group performed bronchoscopy alveolar lavage on this basis to observe the curative effect.Results:Before treatment,there was no significant difference in serum factor indexes and blood gas analysis indexes between the two groups of patients,P>0.05.After treatment,the time of fever,cough,moist rales disappearing and infection control time in the study group were shorter than those in the reference group,P<0.05.Serum tumor necrosis factorα(TNF-α),interleukin-6(IL-6)and interleukin-8(IL-8)levels were lower than the reference group,and the arterial partial pressure of oxygen(PO2)and oxygen saturation(SO2)were both lower than the reference group,P<0.05.The effective rate of the treatment in the study group was higher than that in the reference group,P<0.05.Conclusion:Bronchoscopic alveolar lavage treatment can effectively improve the clinical symptoms of patients with severe pneumonia caused by multi-drug resistant bacterial infection,and the effects are significant.展开更多
Objective:To investigate the influencing factors of multi-drug resistant bacterial infections in patients with severe disease and establish a predictive model.Methods:207 infected patients in our hospital from 2018 to...Objective:To investigate the influencing factors of multi-drug resistant bacterial infections in patients with severe disease and establish a predictive model.Methods:207 infected patients in our hospital from 2018 to May 2020 were selected for the study,of which 73 carried drug-resistant bacteria.Results:The risk factor network of people infected with multidrug resistant bacteria is higher than that of people infected with non-multidrug resistant bacteria,and the interaction between risk factors of the former is stronger.Conclusion:Antibiotics must be used appropriately after surgery.When the elderly was abnormal in indicators such as fever and procalcitonin in the ward,they should be considered as high-risk groups of MDRO infection.They need special care and preventive measures.展开更多
Aim/Objective: Increase in incidences of pneumonia due to multi-drug resistant methicillin resistant Staphylococcus aureus (MRSA) in both community and health care settings is of great concern globally. Present study ...Aim/Objective: Increase in incidences of pneumonia due to multi-drug resistant methicillin resistant Staphylococcus aureus (MRSA) in both community and health care settings is of great concern globally. Present study aims to retrospectively analyze the efficacy of new fixed dose combination with antibiotic adjuvant entity (FDC) in comparison with vancomycin to treat patients with multi-drug resistant MRSA pneumonia. Materials and Methods: During this retrospective study, case sheets of patients who were treated for MRSA pneumonia with vancomycin or fixed dose combination of vancomycin + ceftriaxone + adjuvant (FDC) between 20 March 2010 to 20 October 2014 at tertiary care center, were analyzed. Various demographic features, antibiotic therapy, length of treatment duration and the resulting efficacy were evaluated. Microbiological success was measured in terms of bacterial eradication, while clinical success was monitored in terms of complete omission of systemic signs and symptoms. Results: Among 136 patients analyzed, 113 cases were having positive culture for MRSA, and hence were further analyzed. Out of these 113 patients, empirical treatment with vancomycin was given in 59 patients and 54 patients were treated with FDC empirically. After initial culture reports, 22 patients showing resistance to vancomycin were shifted to FDC. Amidst all the patients, 24 (64.86%) of 37 from vancomycin group and 62 (81.57%) of 76 from FDC group achieved clinical success. 9 patients out of these failure cases were cured with FDC + colistin combination therapy. Failure rates in FDC treated patients were significantly low (6.57%) as compared to vancomycin group (13.51%). Conclusion: For the treatment of different types of multi-drug resistant MRSA pneumonia, the empirical intravenous FDC therapy was safe and well tolerated with higher efficacy than vancomycin. Most of the vancomycin failure cases responded to FDC therapy and were cured. This retrospective study also concludes that an alternative option of FDC + colistin is safe and effective to treat the patients which fail to respond to FDC monotherapy.展开更多
目的通过探讨重症监护室(intensive care unit,ICU)机械通气重症肺炎患者多重耐药菌(multi-drug resistant organisms,MDROs)感染的危险因素,构建ICU机械通气重症肺炎患者MDROs感染的列线图模型。方法选取2019年5月至2022年11月收入合...目的通过探讨重症监护室(intensive care unit,ICU)机械通气重症肺炎患者多重耐药菌(multi-drug resistant organisms,MDROs)感染的危险因素,构建ICU机械通气重症肺炎患者MDROs感染的列线图模型。方法选取2019年5月至2022年11月收入合肥市第三人民医院ICU的240例机械通气重症肺炎患者作为研究对象,根据MDROs感染情况分为MDROs感染组和无MDROs感染组。采用Lasso分析筛选ICU机械通气重症肺炎患者MDROs感染的预测因素,采用Logistic回归筛选ICU机械通气重症肺炎患者MDROs感染的危险因素,采用R软件构建ICU机械通气重症肺炎患者MDROs感染的列线图模型,并对ICU机械通气重症肺炎患者MDROs感染的列线图模型进行内部验证。结果240例ICU机械通气重症肺炎患者中有94例发生MDROs感染,MDROs感染的发生率为39.17%。Logistic回归分析结果显示,糖尿病、低蛋白血症、意识障碍、院内获得性肺炎等是ICU机械通气重症肺炎患者MDROs感染的危险因素(P均<0.05)。ICU机械通气重症肺炎患者MDROs感染的列线图模型校正曲线的预测值与实际值的一致性良好;模型的受试者工作曲线下面积为0.721(95%置信区间:0.653~0.790);决策曲线显示阈值概率是19%~100%时,列线图预测ICU机械通气重症肺炎患者MDROs感染的净获益值较高。结论本研究构建的ICU机械通气重症肺炎患者MDROs感染的列线图模型的准确性及临床应用价值较高。展开更多
目的探讨头孢哌酮钠舒巴坦钠(cefoperazone sodium and sulbactam sodium,CSSS)联合替加环素(tigacycline,TG)治疗多重耐药菌重症肺炎的疗效。方法选取2020年1月—2022年6月苏州市吴中人民医院收治的72例重症肺炎患者为研究对象,随机分...目的探讨头孢哌酮钠舒巴坦钠(cefoperazone sodium and sulbactam sodium,CSSS)联合替加环素(tigacycline,TG)治疗多重耐药菌重症肺炎的疗效。方法选取2020年1月—2022年6月苏州市吴中人民医院收治的72例重症肺炎患者为研究对象,随机分成两组,各36例。对照组单纯以CSSS抗菌治疗,观察组在对照组基础上联合TG抗菌治疗。对比两组患者症状改善、疗效、抗菌效果、不良反应。结果观察组治疗总有效率91.67%,高于对照组的66.67%,差异有统计学意义(χ^(2)=6.821,P<0.05)。观察组清除率80.56%,高于对照组的58.33%,差异有统计学意义(χ^(2)=4.189,P<0.05);观察组体温复常、胸片正常、啰音消失、住院时间为(5.49±1.92)、(12.58±3.92)、(10.83±2.71)、(16.71±5.16)d低于对照组的(7.27±2.36)、(16.14±4.23)、(13.41±2.76)、(20.67±5.47)d,差异有统计学意义(t=3.510、3.704、4.000、3.160,P<0.05);观察组不良反应发生率为8.33%,对照组发生率为5.56%,差异无统计学意义(P>0.05)。结论CSSS联合TG在治疗多重耐药菌重症肺炎具有良好的疗效和抗菌效果,可缩短患者病程,同时联合用药安全性也能保障,不良反应风险低。展开更多
基金Fund project no.:2020-SW(reserved)-52Kunming Health Commission 1000 project reserved candidates:Study on the diagnostic value of BALF solution acer sequencing and culturing in difficult and severe respiratory infections.
文摘Objective:To explore the effects of bronchoscopy alveolar lavage in the treatment of severe pneumonia caused by multiple drug bacterial infection.Methods:A total of 84 patients with severe pneumonia infected by multi-drug resistant bacteria were randomly selected from Kunming Second People's Hospital,which is our hospital from January 2019 to December 2020 for this research.They were divided into a reference group and a study group using a digital table method,with 42 cases in each group.The reference group was given the routine treatment,the research group performed bronchoscopy alveolar lavage on this basis to observe the curative effect.Results:Before treatment,there was no significant difference in serum factor indexes and blood gas analysis indexes between the two groups of patients,P>0.05.After treatment,the time of fever,cough,moist rales disappearing and infection control time in the study group were shorter than those in the reference group,P<0.05.Serum tumor necrosis factorα(TNF-α),interleukin-6(IL-6)and interleukin-8(IL-8)levels were lower than the reference group,and the arterial partial pressure of oxygen(PO2)and oxygen saturation(SO2)were both lower than the reference group,P<0.05.The effective rate of the treatment in the study group was higher than that in the reference group,P<0.05.Conclusion:Bronchoscopic alveolar lavage treatment can effectively improve the clinical symptoms of patients with severe pneumonia caused by multi-drug resistant bacterial infection,and the effects are significant.
文摘Objective:To investigate the influencing factors of multi-drug resistant bacterial infections in patients with severe disease and establish a predictive model.Methods:207 infected patients in our hospital from 2018 to May 2020 were selected for the study,of which 73 carried drug-resistant bacteria.Results:The risk factor network of people infected with multidrug resistant bacteria is higher than that of people infected with non-multidrug resistant bacteria,and the interaction between risk factors of the former is stronger.Conclusion:Antibiotics must be used appropriately after surgery.When the elderly was abnormal in indicators such as fever and procalcitonin in the ward,they should be considered as high-risk groups of MDRO infection.They need special care and preventive measures.
文摘Aim/Objective: Increase in incidences of pneumonia due to multi-drug resistant methicillin resistant Staphylococcus aureus (MRSA) in both community and health care settings is of great concern globally. Present study aims to retrospectively analyze the efficacy of new fixed dose combination with antibiotic adjuvant entity (FDC) in comparison with vancomycin to treat patients with multi-drug resistant MRSA pneumonia. Materials and Methods: During this retrospective study, case sheets of patients who were treated for MRSA pneumonia with vancomycin or fixed dose combination of vancomycin + ceftriaxone + adjuvant (FDC) between 20 March 2010 to 20 October 2014 at tertiary care center, were analyzed. Various demographic features, antibiotic therapy, length of treatment duration and the resulting efficacy were evaluated. Microbiological success was measured in terms of bacterial eradication, while clinical success was monitored in terms of complete omission of systemic signs and symptoms. Results: Among 136 patients analyzed, 113 cases were having positive culture for MRSA, and hence were further analyzed. Out of these 113 patients, empirical treatment with vancomycin was given in 59 patients and 54 patients were treated with FDC empirically. After initial culture reports, 22 patients showing resistance to vancomycin were shifted to FDC. Amidst all the patients, 24 (64.86%) of 37 from vancomycin group and 62 (81.57%) of 76 from FDC group achieved clinical success. 9 patients out of these failure cases were cured with FDC + colistin combination therapy. Failure rates in FDC treated patients were significantly low (6.57%) as compared to vancomycin group (13.51%). Conclusion: For the treatment of different types of multi-drug resistant MRSA pneumonia, the empirical intravenous FDC therapy was safe and well tolerated with higher efficacy than vancomycin. Most of the vancomycin failure cases responded to FDC therapy and were cured. This retrospective study also concludes that an alternative option of FDC + colistin is safe and effective to treat the patients which fail to respond to FDC monotherapy.
文摘目的通过探讨重症监护室(intensive care unit,ICU)机械通气重症肺炎患者多重耐药菌(multi-drug resistant organisms,MDROs)感染的危险因素,构建ICU机械通气重症肺炎患者MDROs感染的列线图模型。方法选取2019年5月至2022年11月收入合肥市第三人民医院ICU的240例机械通气重症肺炎患者作为研究对象,根据MDROs感染情况分为MDROs感染组和无MDROs感染组。采用Lasso分析筛选ICU机械通气重症肺炎患者MDROs感染的预测因素,采用Logistic回归筛选ICU机械通气重症肺炎患者MDROs感染的危险因素,采用R软件构建ICU机械通气重症肺炎患者MDROs感染的列线图模型,并对ICU机械通气重症肺炎患者MDROs感染的列线图模型进行内部验证。结果240例ICU机械通气重症肺炎患者中有94例发生MDROs感染,MDROs感染的发生率为39.17%。Logistic回归分析结果显示,糖尿病、低蛋白血症、意识障碍、院内获得性肺炎等是ICU机械通气重症肺炎患者MDROs感染的危险因素(P均<0.05)。ICU机械通气重症肺炎患者MDROs感染的列线图模型校正曲线的预测值与实际值的一致性良好;模型的受试者工作曲线下面积为0.721(95%置信区间:0.653~0.790);决策曲线显示阈值概率是19%~100%时,列线图预测ICU机械通气重症肺炎患者MDROs感染的净获益值较高。结论本研究构建的ICU机械通气重症肺炎患者MDROs感染的列线图模型的准确性及临床应用价值较高。
文摘目的探讨头孢哌酮钠舒巴坦钠(cefoperazone sodium and sulbactam sodium,CSSS)联合替加环素(tigacycline,TG)治疗多重耐药菌重症肺炎的疗效。方法选取2020年1月—2022年6月苏州市吴中人民医院收治的72例重症肺炎患者为研究对象,随机分成两组,各36例。对照组单纯以CSSS抗菌治疗,观察组在对照组基础上联合TG抗菌治疗。对比两组患者症状改善、疗效、抗菌效果、不良反应。结果观察组治疗总有效率91.67%,高于对照组的66.67%,差异有统计学意义(χ^(2)=6.821,P<0.05)。观察组清除率80.56%,高于对照组的58.33%,差异有统计学意义(χ^(2)=4.189,P<0.05);观察组体温复常、胸片正常、啰音消失、住院时间为(5.49±1.92)、(12.58±3.92)、(10.83±2.71)、(16.71±5.16)d低于对照组的(7.27±2.36)、(16.14±4.23)、(13.41±2.76)、(20.67±5.47)d,差异有统计学意义(t=3.510、3.704、4.000、3.160,P<0.05);观察组不良反应发生率为8.33%,对照组发生率为5.56%,差异无统计学意义(P>0.05)。结论CSSS联合TG在治疗多重耐药菌重症肺炎具有良好的疗效和抗菌效果,可缩短患者病程,同时联合用药安全性也能保障,不良反应风险低。
