摘要
目的探讨头孢他啶-阿维巴坦(CZA)治疗耐碳青霉烯耐药的肺炎克雷伯菌(CRKP)脓毒性休克的效果和安全性。方法回顾性分析2019年8月至2020年5月在上海市同济大学附属东方医院RICU收住的4例经CZA治疗的CRKP感染致脓毒性休克患者的临床资料。收集患者的临床特征、生化指标、细菌培养及药敏试验结果、抗菌药物种类、CZA治疗前后的序贯器官衰竭估计评分(SOFA)评分,评估患者临床疗效、用药不良反应等。结果4例患者中女性2例,男性2例,年龄72~79岁。分别在肺泡灌洗液、胆汁引流液或血液标本中检出肺炎克雷伯菌,培阳标本的药敏试验均提示碳青霉烯类抗生素耐药,对CZA敏感。经CZA治疗后患者SOFA评分、临床表现、炎症指标等均明显好转。4例患者均好转出院,未发现抗感染药物治疗相关的不良反应。结论CZA对耐碳青霉烯肺炎克雷伯菌感染导致的脓毒性休克具有良好的疗效和安全性。
Objective To investigate efficacy and safety of Ceftazidime-Avibactam(CZA)in the treatment of septic shock patients infected by carbapenem-resistant Klebsiella pneumoniae(CRKP).Methods Clinical data of 4 patients with septic shock caused by CRKP infection who were treated with CZA was retrospectively analyzed.Sequential organ failure assessment(SOFA)score before and after CZA treatment was collected for clinical efficacy and side effect assessment.Results Among these 4 patients,2 were female and 2 were male,aged 72-79 years.Klebsiella pneumoniae was cultured from alveolar lavage fluid,drainaged bile or blood samples,respectively.All cultures of Klebsiella pneumoniae were carbapenemresistent but sensitive to CZA.After CZA prescription,SOFA score,clinical manifestations and inflammatory biomarkers of these patients were significantly improved and they all discharged home.No side effects related to CZA were reported.Conclusion CZA is effective and safe for septic shock patients infected by carbapenem resistant Klebsiella pneumoniae.
作者
孙禾
何春凤
吴晓东
韩蕙泽
施毅
李强
Sun He;He Chunfeng;Wu Xiaodong;Han Huize;Shi Yi;Li Qiang(Department of Respiratory and Critical Care Medicine,East Hospital of Tongji University,Shanghai 200120,China;Department of Respiratory and Critical Care Medicine,Nanjing Jinling Hospital,Nanjing University,School of Medicine,Nanjing 210002,China)
出处
《中华重症医学电子杂志》
CSCD
2021年第1期76-80,共5页
Chinese Journal Of Critical Care & Intensive Care Medicine(Electronic Edition)
