上海交通大学学报（医学版）

›› 2011, Vol. 31 ›› Issue (1): 111-.doi: 10.3969/j.issn.1674-8115.2011.01.026

• 短篇论著 • 上一篇    下一篇

不同抗菌药物对ICU泛耐药鲍曼不动杆菌感染的疗效比较

王 刚1, 黄 洁2, 秦 帅2, 汤耀卿2   

  1. 1.四川省都江堰人民医院重症监护病房, 都江堰 611830；2.上海交通大学 医学院附属瑞金医院重症监护病房, 上海 200025
  • 出版日期:2011-01-28 发布日期:2011-02-01
  • 通讯作者: 黄 洁, 电子信箱: seaky1229@hotmail.com。
  • 作者简介:王 刚（1971—）, 男, 主治医师, 学士；电子信箱: 1594799829@vqq.com。

Efficacy of different antibiotics in management of pan-drug-resistant Acinetobacter baumannii infection in ICU

WANG Gang1, HUANG Jie2, QIN Shuai2, TANG Yao-qing2   

  1. 1.Department of Intensive Care Unit, Dujiangyan People's Hospital, Dujiangyan 611830, China；2.Department of Intensive Care Unit, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China
  • Online:2011-01-28 Published:2011-02-01

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摘要：

目的 比较不同抗菌药物对泛耐药鲍曼不动杆菌（PDR-AB）感染的疗效，为临床抗PDR-AB感染治疗提供有效方案和依据。方法 回顾性分析20例PDR-AB严重感染患者的感染特点、抗菌药物选择及疗效。结果 20例PDR-AB感染患者均接受头孢哌酮－舒巴坦治疗，其中7例为大剂量（9～12 g/d）单独治疗，13例分别联合米诺环素或左氧氟沙星治疗；平均疗程（13.3±5.3）d，临床有效率50.0%，细菌清除率35.0%。10例经上述治疗无效的患者中有5例改为注射硫酸多黏菌素E治疗，平均疗程（16.8±5.0）d，临床有效率80.0%，细菌清除率60.0%。20例患者总临床有效率70.0%，细菌清除率50.0%，病死率30.0%。结论 头孢哌酮－舒巴坦大剂量应用或联合米诺环素对PDR-AB感染有一定疗效，是国内治疗PDR-AB感染的首选；多黏菌素E对PDR-AB感染的疗效也较好，可作为治疗PDR-AB感染的有效选择，但国内尚缺乏上市产品。

关键词: 泛耐药, 鲍曼不动杆菌, 感染

Abstract:

Objective To investigate the efficacy of different antibiotics for the treatment of pan-drug-resistant Acinetobacter baumannii (PDR-AB) infection. Methods The clinical characteristics, application of antibiotics and outcomes of 20 patients with severe PDR-AB infection were retrospectively analysed. Results Seven patients were treated with highdose cefoperazone-sulbactam monotherapy (9 to 12 g/d), and the other 13 were managed with cefoperazonesulbactam combined with levofloxacin or minocycline, with the mean course of treatment of (13.3±5.3）d, clinical effective rate of 50.0% and bacteria clearance rate of 35.0%. Five of the 10 patients unresponsive to the initial therapy were administrated with colistin sulfate, with the mean course of treatment of (16.8±5.0）d, clinical effective rate of 80.0% and bacteria clearance rate of 60.0%. For all the 20 patients, the total clinical effective rate was 70.0%, the bacteria clearance rate was 50.0%, and the mortality was 30.0%. Conclusion For the management of PDR-AB infection, highdose cefoperazone-sulbactam with or without minocycline may be effective, and colistin is also viable and safe with a favorable clinical outcome.

Key words: pan-drug-resistant, Acinetobacter baumannii, infection