多黏菌素B治疗血液系统恶性肿瘤伴CRKP-BSI的临床观察 点击下载
论文标题: 多黏菌素B治疗血液系统恶性肿瘤伴CRKP-BSI的临床观察
英文标题:
中文摘要: 目的 分析多黏菌素B治疗血液系统恶性肿瘤伴耐碳青霉烯类肺炎克雷伯菌(CRKP)-血流感染(BSI)的有效性和安全性。方法回顾性分析2019年9月-2021年6月于我院接受至少3d多黏菌素B治疗的血液系统恶性肿瘤伴CRKP-BSI患者的资料。所有患者初始均采用以多黏菌素B+替加环素+碳青霉烯类药物为基础的三联治疗方案。结果共纳入10例患者,血培养检出11株CRKP,其中10株CRKP产肺炎克雷伯菌碳青霉烯酶(KPC),1株CRKP同时产KPC和金属β-内酰胺酶;9株对黏菌素敏感,7株对替加环素敏感,5株对阿米卡星敏感,2株对复方磺胺甲噁唑敏感。所有患者均伴有中性粒细胞减少,平均持续时间为(14.1±6.4)d;均表现为发热、寒颤、乏力。经治疗后,有6例患者治愈出院,4例患者因感染性休克治疗无效死亡;所有患者未发生多黏菌素B相关的严重不良事件。结论多黏菌素B可作为血液系统恶性肿瘤伴CRKP-BSI患者的治疗用药,治疗期间均未发生多黏菌素B相关的严重不良事件。
英文摘要: OBJECTIVE To analyze the efficacy and safety of polymyxin B in the treatment of carbapenem-resistant Klebsiella pneumoniae (CRKP)-bloodstream infection (BSI) in patients with hematologic malignancies. METHODS The medical records of patients with hematologic malignancies with CRKP-BSI who received polymyxin B for at least 3 days in our hospital from September 2019 to June 2021 were retrospectively analyzed. All patients were initially treated with a triple therapy namely polymyxin B+tigecycline+carbapenems for anti-infection therapy. RESULTS A total of 10 patients were enrolled as the study subjects. Eleven strains of CRKP were cultured in blood, including 10 strains of CRKP produced Klebsiella pneumoniae carbapenemase(KPC) and 1 strain of CRKP produced both KPC and metal-beta-lactamase; 9 strains were sensitive to colistin, 7 strains were sensitive to tigecycline, 5 strains were sensitive to amikacin and 2 strains were sensitive to compound sulfamethoxazole. All patients were accompanied by neutropenia, with an average duration of (14.1±6.4) days. They were all characterized by fever, chills and fatigue. After treatment, 6 patients were cured and discharged, 4 patients died of ineffective treatment of septic shock. No serious adverse events related to polymyxin B occurred in all patients. CONCLUSIONS Polymyxin B can be used as a therapeutic drug for CRKP-BSI in patients with hematological malignancies. No serious adverse event related to polymyxin B occurs during the treatment.
期刊: 2023年第34卷第04期
作者: 李纳;刘楠;张爱玲;李丽;万鼎铭;张晓坚
英文作者: LI Na,LIU Nan,ZHANG Ailing,LI Li,WAN Dingming,ZHANG Xiaojian
关键字: 多黏菌素B;耐碳青霉烯类肺炎克雷伯菌;血液系统恶性肿瘤;血流感染;疗效;安全性
KEYWORDS: polymyxin B; carbapenem-resistant Klebsiella pneumoniae; hematologic malignancy; bloodstream infection;
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