中国感染控制杂志2024，Vol.23Issue(4)：458-466,9.DOI:10.12138/j.issn.1671-9638.20244884
联合多黏菌素类药物治疗对头孢他啶/阿维巴坦耐药的耐碳青霉烯类革兰阴性菌感染的临床疗效
Clinical efficacy of polymyxin combination in the treatment of ceftazi-dime/avibactam-resistant carbapenem-resistant Gram-negative bacteria in-fection
刘亭亭 1陈晓燚 1赵宇蕾 1刘雪姣 1岳慧杰1
作者信息
- 1. 东部战区总医院临床药学科,江苏南京 210002
- 折叠
摘要
Abstract
Objective To preliminarily evaluate the clinical efficacy of polymyxin combination treatment in patients with ceftazidime/avibactam(CZA)-resistant(inhibition zone diameter of CZA measured by disc diffusion method was≤22 mm)carbapenem-resistant Gram-negative bacteria(CR-GNB)infection.Methods Hospitalized patients who received polymyxin combination for the treatment of CZA-resistant CR-GNB infection in a hospital from June 2021 to May 2023 were included in the study.According to the antimicrobial susceptibility results of CZA by disc diffu-sion method,patients were divided into CZA inhibition zone diameter 20-22 mm group and CZA inhibition zone dia-meter＜20 mm group.Clinical efficacy and safety of anti-infection treatment in the two groups of patients were ob-served.Results A total of 75 patients were enrolled,including 41 patients with CZA inhibition zone diameter 20-22 mm and 34 patients with CZA inhibition zone diameter＜20 mm.The general data between the two groups of pa-tients were not statistically different(all P＞0.05).The proportion of the types,dosage and combination regimens of polymyxins between the two groups of patients were not statistically different(all P＞0.05).The number of bac-terial strains and the diameter of CZA inhibition zone of different types of CR-GNB isolates between the two groups were all statistically different(all P＜0.05).Clinical effective rate,microbiological clearance rate,28-day mortali-ty,and discharge mortality between the two groups of patients were not statistically different(all P＞0.05).Changes in renal safety indexes between the two groups of patients before and after treatment with polymyxins were not statistically different(all P＞0.05).Conclusion Clinical and microbiological efficacy of combination treatment with polymyxins for CZA-resistant CR-GNB infected patients is approximately 50％.The efficacy of polymyxin combination in the treatment of infection caused by strains with inhibitory zone diameter＜20 mm is consistent with those with diameter of 20-22 mm,but further validation with a larger size of clinical specimens is needed.关键词
多黏菌素/头孢他啶/阿维巴坦耐药/耐碳青霉烯类革兰阴性菌/临床疗效/微生物学疗效Key words
polymyxin/ceftazidime/avibactam resistance/carbapenem-resistant Gram-negative bacteria/clinical efficacy/microbiological efficacy分类
医药卫生引用本文复制引用
刘亭亭,陈晓燚,赵宇蕾,刘雪姣,岳慧杰..联合多黏菌素类药物治疗对头孢他啶/阿维巴坦耐药的耐碳青霉烯类革兰阴性菌感染的临床疗效[J].中国感染控制杂志,2024,23(4):458-466,9.
