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《Chinese Journal of Lung Diseases(Electronic Edition)》 2019-03
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Effect of tigecycline on anti-infection treatment of NICU patients with hospital-acquired pneumonia caused by carbapenem-resistant bacteria

Duan Wei;Fan Qinlin;Liu Yong;Department of Neurology,Xinqiao Hospital,Army Military Medical University;  
Objective To provide theoretical evidences,we analyzed the effect of tigecycline on the anti-infection treatment of the patients with hospital-acquired pneumonia caused by carbapenem-resistant bacteria in the Neurosurgical Intensive Care Unit( NICU) in our hospital. Methods The clinical data of 131 NICU patients with hospital-acquired pneumonia caused by carbapenem-resistant bacteria from May 2015 to November 2018 were analyzed retrospectively. According to the results of sputum bacterial culture,they were divided into an extensively drug-resistant Acinetobacter baumannii positive group and an extensively drugresistant Klebsiella pneumoniae positive group. Then the patients received the following three anti-infective treatments,respectively: tigecycline combined with meropenem,tigecycline combined with imipenem-cilastatin sodium,and tigecycline combined with cefoperazone/sulbactam. Then Student' s t test or chi-square test were used to analyze the data among the three treated groups including the clinical characteristics, clinical efficiency,microbiological eradication rate and inflammatory markers. Logistic regression analysis was used to determine the risk factors related to the clinical cure rate. Results ①Compared with the other two groups,the clinical efficiency of the group of tigecycline combined with meropenem was the most highest in the extensively drug resistant Acinetobacter baumannii positive group( 63. 64%, P 0. 05). There were no significant differences in the clinical efficiencies of the three treatment groups in the extensively drug resistant Klebsiella pneumoniae positive group( P0.05). ②There were no significant differences in the microbiological eradication rates of the three treatment groups in both extensively drug resistant Klebsiella pneumoniae positive group and Acinetobacter baumannii positive group( P 0. 05). ③ Compared with the inflammatory markers before antiinfective treatments,the inflammatory markers of all the groups,such as white blood cell count,C reaction protein and procalcitonin,were significantly decreased after anti-infectice treatments( P0.05). ④The results of Logistic regression analysis showed that the markers,such as gender,tracheal intubation/tracheotomy,the values of C reaction protein and procalcitonin,before anti-infective treatments,had a significant impact on the clinical efficiency( P 0. 05). Conclusion Tigecycline combined treatments can achieve better clinical therapeutic effects on the NICU patients with hospital-acquired pneumonia caused by carbapenem-resistant bacterias. Acinetobacter baumannii is the main extensively drug-resistant strain in our NICU. Treatment of tigecycline combined with meropenem has a significant anti-infective effect on the patients with hospital-acquired pneumonia caused by the extensively drug resistant Acinetobacter baumannii.
【Fund】: 陆军军医大学(第三军医大学)第二附属医院临床科研项目(No.2015YLC14)
【CateGory Index】: R563.1
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