Objective To evaluate clinical efficacy of tigecycline alone or in combination with other antimicrobials in treating infection caused by carbapenem-resistant Acinetobacter baumannii (CRAB).Methods Patients with hos-pital-acquired pneumonia (HAP)and/or bloodstream infection in the intensive care unit of a hospital between Janu-ary 2013 and June 2014 were selected,efficacy of tigecycline treatment was analyzed.Results Of 25 patients with CRAB infection,21 were with HAP,2 with bloodstream infection,and 2 with both HAP and bloodstream infec-tion.13 cases were multidrug-resistant Acinetobacter baumannii (MDRAB), 10 cases were extensively drug-resistant Acinetobacter baumannii (XDRAB).The susceptibility rate of 25 CRAB isolates to tigecycline was 84%. After treated with tigecycline,white blood cell count(WBC),C-reactive protein (CRP),and procalcitonin (PCT) all significantly decreased (all P<0.01).The clinical effective rate,bacterial clearance rate,and 30-day mortality were 68.00% (17/25),66.67%(14/21),and 28.00% (7/25)respectively;effective rate of 21 cases of HAP was 76.19% (16/21),1 case of bloodstream infection was effective,2 cases of HAP combined bloodstream infection died.Conclusion Tigecycline is effective in the treatment of HAP caused by CRAB,but the therapeutic effect on bloodstream remains uncertain,further research is needed.%目的：了解替加环素单药或联合用药治疗耐碳青霉烯鲍曼不动杆菌（CRAB）感染的临床疗效。方法选择某院重症监护病房（ICU）2013年1月—2014年6月 CRAB 医院获得性肺炎（HAP）和血流感染者，分析替加环素的治疗效果。结果25例患者，其中肺部感染21例，血流感染、肺部感染合并血流感染各2例。其中13例为多重耐药鲍曼不动杆菌（MDRAB），10例为泛耐药鲍曼不动杆菌（XDRAB）。25株 CRAB 对替加环素的敏感率为84％。使用替加环素后患者白细胞计数、C 反应蛋白（CRP）和降钙素原（PCT）均呈逐渐下降趋势（均 P ＜0．01）。临床有效率为68．00％（17／25），细菌清除率66．67％（14／21），30 d 病死率为28．00％（7／25）；其中21例肺部感染患者的临床有效率为76．19％（16／21），2例血流感染患者1例有效，2例肺部感染合并血流感染者死亡。结论替加环素对于 CRAB HAP 具有良好疗效，对血流感染的疗效不确切，仍需增大样本量进一步研究。
展开▼
