{"title":"在儿科重症监护病房使用替加环素治疗严重感染","authors":"İrem Ersayoğlu, Pınar Yazıcı Özkaya, Gizem Güner Özenen, Kübra Cebeci, Hatice Feray Arı, Zümrüt Şahbudak Bal, Sabire Şöhret Aydemir, Bülent Karapınar","doi":"10.1055/s-0044-1788342","DOIUrl":null,"url":null,"abstract":"<p>\n<b>Objective</b> To evaluate the effectiveness and safety of using tigecycline as a salvage therapy in critically ill children who did not respond to other antibiotics.</p> <p>\n<b>Methods</b> 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.</p> <p>\n<b>Results</b> 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). <i>Klebsiella pneumoniae</i> (<i>n</i> = 17, 30.9%) was the most frequently isolated pathogen, followed by <i>Acinetobacter baumannii</i> (<i>n</i> = 10, 18.1%). Ventilator-associated pneumonia was the most common infection (<i>n</i> = 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%.</p> <p>\n<b>Conclusion</b> 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.</p> ","PeriodicalId":16739,"journal":{"name":"Journal of Pediatric infectious diseases","volume":"57 1","pages":""},"PeriodicalIF":0.2000,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Tigecycline Usage for Severe Infections in the Pediatric Intensive Care Unit\",\"authors\":\"İrem Ersayoğlu, Pınar Yazıcı Özkaya, Gizem Güner Özenen, Kübra Cebeci, Hatice Feray Arı, Zümrüt Şahbudak Bal, Sabire Şöhret Aydemir, Bülent Karapınar\",\"doi\":\"10.1055/s-0044-1788342\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p>\\n<b>Objective</b> To evaluate the effectiveness and safety of using tigecycline as a salvage therapy in critically ill children who did not respond to other antibiotics.</p> <p>\\n<b>Methods</b> 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.</p> <p>\\n<b>Results</b> 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). <i>Klebsiella pneumoniae</i> (<i>n</i> = 17, 30.9%) was the most frequently isolated pathogen, followed by <i>Acinetobacter baumannii</i> (<i>n</i> = 10, 18.1%). Ventilator-associated pneumonia was the most common infection (<i>n</i> = 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%.</p> <p>\\n<b>Conclusion</b> 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.</p> \",\"PeriodicalId\":16739,\"journal\":{\"name\":\"Journal of Pediatric infectious diseases\",\"volume\":\"57 1\",\"pages\":\"\"},\"PeriodicalIF\":0.2000,\"publicationDate\":\"2024-08-02\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Pediatric infectious diseases\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1055/s-0044-1788342\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"INFECTIOUS DISEASES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Pediatric infectious diseases","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1055/s-0044-1788342","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}
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.
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.