在儿科重症监护病房使用替加环素治疗严重感染

IF 0.2 4区 医学 Q4 INFECTIOUS DISEASES Journal of Pediatric infectious diseases Pub Date : 2024-08-02 DOI:10.1055/s-0044-1788342
İrem Ersayoğlu, Pınar Yazıcı Özkaya, Gizem Güner Özenen, Kübra Cebeci, Hatice Feray Arı, Zümrüt Şahbudak Bal, Sabire Şöhret Aydemir, Bülent Karapınar
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引用次数: 0

摘要

目的 评估对其他抗生素无效的重症患儿使用替加环素作为挽救疗法的有效性和安全性。方法 我们进行了一项回顾性队列分析,纳入了在儿科重症监护病房住院期间接受替加环素治疗至少 48 小时和四次剂量的患儿。通过全面审查病历,对受试者的人口统计学和临床特征进行了评估。通过全面评估临床和微生物学结果来评估替加环素的有效性。结果 在研究期间,72 名儿科患者共发生 88 次感染,62.5% 的病例根据抗菌药敏感性接受了替加环素治疗,37.5% 的病例根据经验接受了替加环素治疗。替加环素治疗的中位持续时间为 10 天(2-33 天不等)。肺炎克雷伯菌(17 人,占 30.9%)是最常见的分离病原体,其次是鲍曼不动杆菌(10 人,占 18.1%)。呼吸机相关肺炎是最常见的感染(29 例)。在分离出的 55 种病原体中,43 种是耐多药(MDR)细菌,2 种是广泛耐药(XDR)革兰氏阴性菌。分别有 42% 和 50.9% 的病例获得了临床应答和微生物学清除。总死亡率为 40.9%,可归因死亡率为 29.5%。结论 在缺乏替代治疗方案的情况下,替加环素可作为感染 MDR 或 XDR 病原体的儿科重症患者的挽救疗法。
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Tigecycline Usage for Severe Infections in the Pediatric Intensive Care Unit

Objective To evaluate the effectiveness and safety of using tigecycline as a salvage therapy in critically ill children who did not respond to other antibiotics.

Methods We conducted a retrospective cohort analysis that included children who received tigecycline for at least 48 hours and four doses during their pediatric intensive care unit admission. Demographic and clinical features of the subjects were evaluated through a comprehensive review of medical records. The effectiveness of tigecycline was assessed by thoroughly evaluating clinical and microbiological outcomes.

Results During the study period, 72 pediatric patients with 88 episodes of infection received tigecycline according to antimicrobial susceptibility in 62.5% of cases and empirically in 37.5%. The median duration of tigecycline therapy was 10 days (range, 2–33 days). Klebsiella pneumoniae (n = 17, 30.9%) was the most frequently isolated pathogen, followed by Acinetobacter baumannii (n = 10, 18.1%). Ventilator-associated pneumonia was the most common infection (n = 29). Of the 55 isolated pathogens, 43 were multidrug-resistant (MDR), and 2 were extensively drug-resistant (XDR) gram-negative bacteria. Clinical response and microbiological clearance were achieved in 42 and 50.9% of episodes, respectively. The overall mortality was 40.9%, with an attributable mortality rate of 29.5%.

Conclusion Tigecycline could be used as a salvage therapy for critically ill pediatric patients infected with MDR or XDR pathogens in the lack of alternative treatment options.

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来源期刊
Journal of Pediatric infectious diseases
Journal of Pediatric infectious diseases Medicine-Pediatrics, Perinatology and Child Health
CiteScore
0.60
自引率
0.00%
发文量
50
期刊介绍: The Journal of Pediatric Infectious Diseases is a peer-reviewed medical journal publishing articles in the field of child infectious diseases. The journal provides an in-depth update on new subjects and current comprehensive coverage of the latest techniques used in diagnosis and treatment of childhood infectious diseases. The following articles will be considered for publication: editorials, original and review articles, rapid communications, letters to the editor and book reviews. The aim of the journal is to share and disseminate knowledge between all disciplines in the field of pediatric infectious diseases.
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