• 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>Southern African Journal of Critical Care >Comparison of the efficacy of colistin monotherapy and colistin combination therapies in the treatment of nosocomial pneumonia and ventilator-associated pneumonia caused by Acinetobacter baumannii
【24h】

Comparison of the efficacy of colistin monotherapy and colistin combination therapies in the treatment of nosocomial pneumonia and ventilator-associated pneumonia caused by Acinetobacter baumannii

机译：大肠菌素单药治疗和大肠菌素联合疗法治疗鲍曼不动杆菌引起的医院内肺炎和呼吸机相关性肺炎的疗效比较

获取原文
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

OBJECTIVE: To investigate whether there was a difference in mortality, clinical response and bacterial eradication between colistin monotherapy and colistin combination therapies for the treatment of nosocomial pneumonia/ventilator-associated pneumonia (VAP) caused by Acinetobacter baumannii in a medical intensive care unit (ICU METHODS: This retrospective, observational and single-centre study included all patients who were in the medical ICU of Gazi University Medical Faculty Hospital and diagnosed with nosocomial pneumonia/VAP caused by A. baumannii between January 2009 and September 2014 RESULTS: The median age of the 134 patients was 68 years and 53.3% were male. The most common causes of admission were respiratory insufficiency (66.7%) and sepsis/septic shock (54.8%). In patients with nosocomial pneumonia/VAP caused by A. baumannii, on median day 5 of admission, colistin monotherapy was used in 23 (21.6%) patients, a carbapenem combination was used in 80 (59.7%) patients, sulbactam-ampicillin combination was used in 42 (31.4%) patients, tigecycline combination was used in 26 (19.4%) patients, and sulbactam-cefoperazone combination was used in 17 (12.7%) patients. Median ICU stay of the patients was 15.5 days, and 112 (83.6%) patients died. Colistin monotherapy and combination therapies had no superiority over each other in clinical response for the treatment of A. baumannii-associated nosocomial pneumonia/VAP. Mortality was found to be higher in patients receiving the colistin-carbapenem combination (64.3% v. 36.4%, p=0.016). Discharge/day-of-death Sequential Organ Failure Assessment score (odds ratio (OR) 2.017, 95% confidence interval (CI) 1.330 - 3.061) and vasopressor use (OR 9.014, 95% CI 1.360 - 59.464) were independent risk factors for ICU mortality CONCLUSION: Colistin monotherapy and combination therapies have no superiority over each other for clinical response in the treatment of nosocomial pneumonia/VAP caused by multidrug-resistant A. baumannii. Colistin-SAM was associated with improved microbiological eradication and colistin-carbapenem combination was associated with increased mortality.
机译：目的：探讨在重症监护病房（ICU）中，大肠杆菌素单药疗法和大肠杆菌素联合疗法治疗鲍曼不动杆菌引起的医院内肺炎/呼吸机相关性肺炎（VAP）的死亡率，临床反应和细菌根除是否存在差异方法：这项回顾性，观察性和单中心研究纳入了2009年1月至2014年9月之间在加济大学医学院附属医院的ICU内被诊断出由鲍曼不动杆菌引起的医院内肺炎/ VAP的所有患者。 134例患者为68岁，男性占53.3％，最常见的入院原因是呼吸功能不全（66.7％）和败血症/败血性休克（54.8％）。鲍曼不动杆菌引起的医院内肺炎/ VAP患者的中位数入院第5天，有23例（21.6％）患者使用粘菌素单药治疗，有80例（59.7％）患者使用碳青霉烯类药物联合治疗42例（31.4％）患者使用am-ampillillin组合，26例（19.4％）患者使用tigecycline组合，17例（12.7％）患者使用舒巴坦-头孢哌酮组合。患者的ICU停留中位数为15.5天，死亡112例（83.6％）。在治疗鲍曼不动杆菌相关的医院性肺炎/ VAP的临床反应中，共利斯汀单药疗法和联合疗法在彼此的疗效上没有优势。发现接受粘菌素-卡巴培南联合治疗的患者死亡率更高（64.3％vs. 36.4％，p = 0.016）。出院/死亡日顺序器官衰竭评估得分（优势比（OR）为2.017，95％置信区间（CI）为1.330-3.061）和使用升压药（OR 9.014，95％CI为1.360-59.464）是以下因素的独立危险因素ICU死亡率结论：在治疗多药耐药鲍曼不动杆菌引起的医院内肺炎/ VAP方面，科力汀单一疗法和联合疗法在临床反应方面没有优势。 Colistin-SAM与改善的微生物根除有关，而大肠菌素-卡巴培南组合与死亡率增加有关。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号