优化治疗策略对抗卡巴奈姆抗性青杆菌曼尼相关肺炎:在中国医院的多中心研究
Xiaotong Tian1,2, Jing Lin1,2, Menglan Zhou3,4
1Department of Infectious Disease, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, People's Republic of China.
在CRAB HAP患者中,提格环素 (TGC) 加上赛福拉/苏尔巴克坦 (CPS) 组合治疗显示90天死亡风险更高. 高剂量的TGC加CPS在严重病例中更有效,具有相似的安全性.
科学领域:
- 传染性疾病 传染性疾病
- 关键护理医学 关键护理医学
- 药理学 药理学是指药理学的学科.
背景情况:
- 医院获得的肺炎 (HAP) 是由耐卡巴尼姆抗性巴曼尼菌 (CRAB) 引起的,这给患者带来了重大的治疗挑战.
- 提格环素 (TGC) 和赛福拉/苏尔巴克坦 (CPS) 用于治疗严重的细菌感染,包括由多抗药生物体引起的细菌感染.
研究的目的:
- 为了比较tigecycline (TGC) + cefoperazone/sulbactam (CPS) 与CRAB HAP的TGC单疗的临床结果和安全性.
主要方法:
- 追溯分析来自中国62家医院180名CRAB HAP患者的多中心数据.
- 多变量后勤和考克斯回归分析评估了组合治疗和死亡率预测因素的风险因素.
- 倾向性得分匹配 (PSM) 用于评估不同抗微生物疗法的疗效和安全性.
主要成果:
- 结合疗法 (TGC + CPS) 与TGC单一治疗相比,与90天死亡率的显著更高风险有关.
- 高龄和ICU入院是接受TGC + CPS联合治疗的风险因素.
- 高剂量TGC (HDT) 加上CPS在具有更高SOFA分数和机械通风使用的患者中显示出更好的结果,并降低了CRP水平.
结论:
- 高剂量的TGC加CPS联合治疗在晚年和严重疾病患者中表现出更大的有效性.
- 关于肝脏,脏和凝血功能的安全性概况在不同的抗微生物疗法中是相似的.
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