| 摘要: |
| 目的分析替加环素治疗碳青霉烯类耐药肺炎克雷伯菌（CRKP）肺炎患者的临床疗效及预后。方法回顾性分析21例CRKP肺炎患者的临床特征，采用Cox回归分析患者死亡相关因素和替加环素单药治疗或联合其他抗菌药物治疗的临床疗效及预后。结果基础疾病、年龄和病原菌不影响CRKP肺炎患者住院期间病死率（均P＞0.05），可能与样本量较小有关。替加环素单药治疗9例，有效3例，有效率为33.3%；与其他抗菌药物联合治疗12例，有效9例，有效率为75.0%，治疗效果明显优于替加环素单药治疗（P＜0.05），总临床有效率为52.4%。8例患者治疗后达到细菌学清除标准，清除率为38.0%。CRKP合并铜绿假单胞菌感染最常见，感染率为47.6%，铜绿假单胞菌的存在并未影响患者预后（P＞0.05）。结论替加环素能有效清除CRKP，可作为CRKP肺炎常规抗感染治疗用药，与其他抗菌药物联合使用能有效治疗其他条件致病菌引起的合并感染。 |
| 关键词: 替加环素 耐碳青霉烯类肺炎克雷伯菌 肺炎 疗效 |
| DOI：10.12056/j.issn.1006-2785.2018.40.3.2017-1727 |
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| Efficacy of tigecycline in treatment of carbapenems-resistance Klebiella pneumonia pneumonia |
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Hangzhou Red Cross Hospital
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| Abstract: |
| Objective To evaluate the efficacy of tigecycline in treatment of carbapenems- resistance Klebiella pneumonia (CRKP) pneumonia. Methods The clinical data of 21 patients with CRKP pneumonia treated in our hospital from January 2012 to September 2014 were retrospective analyzed. The clinical efficacy of tigecycline monotherapy (n=9) or in combination with other antibiotics(n=12), and the prognosis of patients were analyzed by COX regression. Results The mortality of CRKP pneumonia patients during hospitalization was not associated with the underlying disease, age and pathogenic bacteria (P ＞0.05). The efficacy rate of tigecycline monotherapy was 33.3%(3/9), which is lower than that of tigecycline combined with
other antibiotics (75.0%, 9/12) (P＜0.05). The total clinical curative effect rate was 52.4%(11/21). Eight cases reached the clear standards of bacteriology (38.0%). Eleven patients were concurrently infected with Pseudomonas aeruginosa (47.6%), however, the prognosis of patients was not affected by mixed infection with Pseudomonas aeruginosa (P ＞0.05). Conclusion Tigecycline can effectively clear CRKP infection, its combination with other antibiotics can be used in treatment of patients with CRKP pneumonia. |
| Key words: Tigecycline Carbapenems-resistance Klebiella pneumonia( CRKP) Pneumonia Curative effect |
