中国感染控制杂志2025，Vol.24Issue(7)：940-946,7.DOI:10.12138/j.issn.1671-9638.20257243
头孢他啶/阿维巴坦治疗肺移植受者肺部感染耐碳青霉烯类革兰阴性菌的疗效及影响因素
Therapeutic efficacy and influencing factors of ceftazidime/avibactam in lung transplant recipients with pulmonary infection caused by carbapenem-resistant Gram-negative bacilli
摘要
Abstract
Objective To investigate the clinical application of ceftazidime/avibactam(CAZ/AVI)in lung trans-plant recipients with pulmonary infection caused by carbapenem-resistant Gram-negative bacilli(CRGNB),and ana-lyze the factors affecting the prognosis.Methods Lung transplant recipients who had CRGNB pulmonary infection and were treated with CAZ/AVI were included in the analysis.Based on 14-day clinical response,14-day microbial response,and 30-day survival status,the recipients were divided into a clinical response group and a clinical failure group,a microbial response group and a microbial failure group,as well as a survival group and a death group,re-spectively.Univariate analysis was conducted on various data from the two groups.Factors affecting therapeutic ef-ficacy and survival were included in a binary logistic regression model.Independent risk factors for CAZ/AVI anti-infective efficacy and all-cause mortality outcomes were analyzed.Results A total of 43 recipients were included.After 14-day anti-infective treatment,32 recipients(74.42％)achieved clinical response,and 30 recipients(69.77％)achieved microbial response.34 recipients(79.07％)survived 30 days after CAZ/AVI treatment.The Charlson comorbidity index(CCI),proportion of renal dysfunction,and incidence of shock in recipients in the clini-cal response group were all lower than those in the clinical failure group(P＜0.05),while the serum albumin(ALB)level was higher(P＜0.05).The incidence of shock in recipients in the microbial response group was lower than that in the microbial failure group(P＜0.05).CCI,proportion of renal dysfunction,and incidence of shock in recipients in the survival group were all lower than those in the death group(all P＜0.05),while ALB level was higher during treatment period(P＜0.05).Multivariate analysis of 14-day clinical response and 30-day survival showed that higher CCI was an independent risk factor affecting 14-day clinical response of recipients(OR=2.22,95％CI:1.07-4.63),while lower ALB levels(OR=0.72,95％CI:0.54-0.98)and higher CCI(OR=5.27,95％CI:1.18-23.58)were independent risk factors for 30-day all-cause mortality in recipients with pulmonary in-fection after lung transplant.Conclusion CAZ/AVI may be an effective drug for treating pulmonary infection caused by CRGNB in lung transplant recipients.Higher CCI is an independent risk factor for 14-day clinical failure in recipients after CAZ/AVI treatment.Lower ALB level and higher CCI are independent risk factors for increased 30-day mortality in recipients.关键词
头孢他啶/阿维巴坦/肺移植受者/肺部感染/耐碳青霉烯类革兰阴性菌/影响因素Key words
cefotaxime/avibactam/lung transplant recipient/pulmonary infection/carbapenem-resistant Gram-negative bacteria/influence factor分类
医药卫生引用本文复制引用
亓志刚,梁城龙,郭雅婷,李小杉,王红梅,史灵芝,吴波,陈静瑜,张秀红..头孢他啶/阿维巴坦治疗肺移植受者肺部感染耐碳青霉烯类革兰阴性菌的疗效及影响因素[J].中国感染控制杂志,2025,24(7):940-946,7.基金项目
南京医科大学无锡医学中心队列与临床研究项目(WMCC202328) （WMCC202328）
