腹腔内感染（intra-abdominal infection,IAI）是一类危害严重的常见感染性疾病。流行病学资料显示约1/4的严重脓毒症或感染性休克由IAI引起,IAI是继肺部感染后,感染性休克的第二大病因[1]。2010年,美国感染病学会（Infectious Diseases...腹腔内感染（intra-abdominal infection,IAI）是一类危害严重的常见感染性疾病。流行病学资料显示约1/4的严重脓毒症或感染性休克由IAI引起,IAI是继肺部感染后,感染性休克的第二大病因[1]。2010年,美国感染病学会（Infectious Diseases Society of America,IDSA）和外科感染学会（Surgical Infection Society of America,SISA）更新发布了复杂腹腔内感染（complicated intra-abdominal infection,c IAI）诊治指南（以下简称IDSA指南）[2],基于循证医学证据,对c IAI的临床诊治提出了指导性意见。展开更多
OBJECTIVES: To describe real-world use of tigecycline in cIAIs patients. METHODS: A retrospective, observational study enrolled cIAIs patients hospitalized in The First Affiliated Hospital, Sun Yat-sen University from...OBJECTIVES: To describe real-world use of tigecycline in cIAIs patients. METHODS: A retrospective, observational study enrolled cIAIs patients hospitalized in The First Affiliated Hospital, Sun Yat-sen University from January 1, 2013 to June 30, 2017 was conducted. Patients’ data were collected and matched based on age, gender, and Acute Physiologic Assessment and Chronic Health Evaluation II (APACHE II) score according to receiving first-line, later-line, or no tigecycline during hospitalization. RESULTS: Data were collected for 52 patients. 82.6% were male. Mean age was 57.8 years and APACHE II score was 14.8. The incidence of both extended-spectrum beta-lactamase producing and carbapenem-resistant pathogens was high on initial culture;however, few patients received first-line tigecycline. No significant difference in mortality rate was identified among first-line, later-line and no tigecycline users. Of surviving patients, shorter hospital length of stay was observed for patients receiving first- vs later-line or no tigecycline, respectively. ICU length-of-stay was shorter in patients receiving first- vs later-line or no tigecycline. CONCLUSIONS: First-line tigecycline use was rare in our surgical intensive care unit. Resistant organisms were commonly cultured from initial specimens. Although these results are limited by small patient numbers and single center, our results suggest that early tigecycline use may have significant benefits with similar mortality. Further research is warranted to demonstrate the values of early tigecycline use in cIAIs patients.展开更多
文摘腹腔内感染（intra-abdominal infection,IAI）是一类危害严重的常见感染性疾病。流行病学资料显示约1/4的严重脓毒症或感染性休克由IAI引起,IAI是继肺部感染后,感染性休克的第二大病因[1]。2010年,美国感染病学会（Infectious Diseases Society of America,IDSA）和外科感染学会（Surgical Infection Society of America,SISA）更新发布了复杂腹腔内感染（complicated intra-abdominal infection,c IAI）诊治指南（以下简称IDSA指南）[2],基于循证医学证据,对c IAI的临床诊治提出了指导性意见。
文摘OBJECTIVES: To describe real-world use of tigecycline in cIAIs patients. METHODS: A retrospective, observational study enrolled cIAIs patients hospitalized in The First Affiliated Hospital, Sun Yat-sen University from January 1, 2013 to June 30, 2017 was conducted. Patients’ data were collected and matched based on age, gender, and Acute Physiologic Assessment and Chronic Health Evaluation II (APACHE II) score according to receiving first-line, later-line, or no tigecycline during hospitalization. RESULTS: Data were collected for 52 patients. 82.6% were male. Mean age was 57.8 years and APACHE II score was 14.8. The incidence of both extended-spectrum beta-lactamase producing and carbapenem-resistant pathogens was high on initial culture;however, few patients received first-line tigecycline. No significant difference in mortality rate was identified among first-line, later-line and no tigecycline users. Of surviving patients, shorter hospital length of stay was observed for patients receiving first- vs later-line or no tigecycline, respectively. ICU length-of-stay was shorter in patients receiving first- vs later-line or no tigecycline. CONCLUSIONS: First-line tigecycline use was rare in our surgical intensive care unit. Resistant organisms were commonly cultured from initial specimens. Although these results are limited by small patient numbers and single center, our results suggest that early tigecycline use may have significant benefits with similar mortality. Further research is warranted to demonstrate the values of early tigecycline use in cIAIs patients.
文摘复杂腹腔内感染(complicated intra-abdominal infection,cIAI)是临床常见疾病,可由多种原因所致,其中消化道穿孔是较为常见的原因,消化道存在特殊解剖结构分层,所以不同部位穿孔所致cIAI的菌群特征和严重程度有所不同。cIAI常由多种病原菌感染引起,病情常较危重,病死率较高,入住重症监护室(intensive care unit,ICU)是危重cIAI患者救治的重要环节。本综述回顾了消化道不同部位穿孔的临床特点、菌群分布特点、所致cIAI的菌群特征、ICU诊断和治疗以及对抗菌药物的选择和耐药风险评估,旨在为临床优化cIAI治疗提供帮助。
