Tigecycline in the treatment of infections from multi-drug resistant gram-negative pathogens
Tigecycline in the treatment of infections from multi-drug resistant gram-negative pathogens
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DOI：
10.1016/j.jinf.2009.02.009
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发表时间：
2009-04-01
影响因子：
28.2
通讯作者：
Giamarellou, Helen
中科院分区：
文献类型：
--
作者：
Poulakou, Garyphallia;Kontopidou, Flora V.;Giamarellou, Helen
目的：这项观察性回顾性研究旨在介绍替加环素 (TIG) 治疗多重耐药 (MDR) 微生物引起的感染的早期经验。方法：纳入成年患者，接受 TIG 超过 5 天的单一疗法（M 组）或假定的活性单一疗法（PAM 组）。在 PAM 组中，所有联合使用的抗菌药物在体外均对目标病原体产生耐药性，或者尽管存在体外敏感性，但在治疗超过 5 天后临床和微生物学均出现失败。 结果：45 名患者（ICU 中 35 名患者）接受了 28 例鲍曼不动杆菌和 23 例肺炎克雷伯菌感染的治疗 [21 例呼吸机相关性和医疗保健获得性肺炎 (VAP/HCAP)， 10 例血流感染 (BSI) 和 14 例手术感染 (SI)]。总体临床结果成功率为 80%，即 M 组为 81.8%，PAM 组为 78.3%，VAP/HCAP 组为 90.5%，BSI 组为 80%，SI 组为 64.3%，感染性休克病例为 85%。 31.8% 的 M 组和 13% 的 PAM 组发生了对替加环素固有耐药的肠杆菌科细菌的重复感染（p
Objective: This observational retrospective study aims to present early experience with tigecycline (TIG) in the treatment of infections due to multi-drug resistant (MDR) microorganisms.Methods: Adult patients included, received TIG for >5 days either as monotherapy (M group) or as presumed active monotherapy (PAM group). In the PAM group, all co-administered antimicrobial(s) were resistant in vitro against the targeted pathogen(s) or had been clinically and microbiologically failing after >5 days of therapy despite in vitro susceptibility.Results: Forty-five patients (35 in ICU) were treated for 28 Acinetobacter baumannii and 23 Klebsiella pneumoniae infections [21 ventilator-associated and healthcare-acquired pneumonia (VAP/HCAP), 10 bloodstream infections (BSI) and 14 surgical infections (SI)]. Successful overall clinical outcome was 80%, i.e. 81.8% in M group, 78.3% in PAM group, 90.5% in VAP/HCAP, 80% in BSI, 64.3% in SI and 85% in the cases with septic shock. Superinfections from Enterobacteriaceae inherently resistant to tigecycline occurred in 31.8% of M and 13% of PAM group (p