全部 标题 作者
关键词 摘要

OALib Journal期刊
ISSN: 2333-9721
费用：99美元
投递稿件

查看量下载量

相关文章

更多...

儿童恶性血液病合并医院获得性肺炎的抗生素疗效分析
Analysis of Antibiotic Efficacy in Children with Tumor of the Hematopoietic and Lymphoid Tissues Complicated with Hospital Acquired Pneumonia

DOI: 10.12677/ACM.2020.109921, PP. 2133-2138

Keywords: 儿童，恶性血液病，医院获得性肺炎，抗生素
Children, Tumor of the Hematopoietic and Lymphoid Tissues, Hospital Acquired Pneumonia, Antibiotics

Full-Text   Cite this paper   Add to My Lib

Abstract:

目的：探讨美罗培南和哌拉西林/他唑巴坦在治疗恶性血液病患儿合并医院获得性肺炎抗生素的疗效，并对其进行安全性分析，为临床用药提供参考。方法：采用回顾性调查分析自2017年1月至2019年9月期间共60例恶性血液病患儿合并医院获得性肺炎的临床资料，根据所用抗生素种类不同分为观察组和对照组。观察组应用美罗培南，共34例；对照组应用哌拉西林/他唑巴坦，共26例；观察两种抗生素的临床疗效及不良反应。结果：两组患儿治疗总有效率观察组为75.3%、对照组为53.8%，两组差异无统计学意义。结论：美罗培南及哌拉西林/他唑巴坦治疗恶性血液病合并医院获得性肺炎在疗效上没有明显差异，均在临床治疗中不良反应较少。
Objective: To evaluate the efficacy and safety of Meropenem and Piperacillin Tazobactam in the treatment of hospital acquired pneumonia in children with tumor of the hematopoietic and lymphoid tissues. Methods: A retrospective study was conducted to analyze the clinical data of 60 children with tumor of the hematopoietic and lymphoid tissues pneumonia from January 2017 to September 2019. The patients were divided into observation group and control group according to the type of antibiotics used. In the observation group, 34 cases were treated with Meropenem; in the control group, 26 cases were treated with Piperacillin/tazobactam. Results: The total effective rate of the two groups was 75.3% in the observation group and 53.8% in the control group. Conclusion: There is no significant difference between Meropenem and Piperacillin Tazobactam in the treatment of tumor of the hematopoietic and lymphoid tissues associated with hospital acquired pneumonia and there are fewer adverse reactions in clinical treatment.

References

[1]  Castagnola, E., Rossi, M.R., Cesaro, S., et al. (2010) Incidence of Bacteremias and Invasive Mycoses in Children with Acute Non-Lymphoblastic Leukemia: Results from a Multi-Center Italian Study. Pediatric Blood & Cancer, 55, 1103-1107.
https://doi.org/10.1002/pbc.22750
[2]  肖秀红, 徐凤琴, 卢妤, 等. 儿科血液病患儿医院血流感染分析[J]. 中外医学研究, 2016,14(25): 125-126+127.
https://doi.org/10.14033/j.cnki.cfmr.2016.25.067
[3]  陈琳, 王津雨, 李睿, 等. 血液病住院患者3年医院感染现患率调查[J]. 中国感染控制杂志, 2017, 16(4): 369-371.
https://doi.org/10.3969/j.issn.1671-9638.2017.04.020
[4]  杜香洲, 杨红, 廖金. 血液病患者医院获得性肺炎临床分析[J]. 中华医院感染学杂志, 2011, 21(2): 254-255.
[5]  中华儿科杂志编辑委员会, 中华医学会儿科学分会呼吸学组, 中华医学会儿科学分会急救学组, 等. 儿童医院获得性肺炎管理方案(2010版) [J]. 中华儿科杂志, 2011, 49(2): 106-115.
https://doi.org/10.3760/cma.j.issn.0578-1310.2011.02.008
[6]  中华医学会. [指南]抗菌药物临床应用指导原则(2004版) [J]. 中华医学会, 2015, 7(9): 118-124.
[7]  姚佳峰, 蔡思雨, 李楠, 等. 2016-2017年单中心血液肿瘤患儿感染病原菌分布的临床特点分析[J]. 北京医学, 2018, 40(4): 301-304.
https://doi.org/10.15932/j.0253-9713.2018.04.004
[8]  Garrido, M.M., Garrido, R.Q., Cunha, T.N., et al. (2019) Comparison of Epidemiological, Clinical and Microbiological Characteristics of Bloodstream Infection in Children with Solid Tumours and Haematological Malignancies. Epidemiol Infect, 147, e298.
https://doi.org/10.1017/S0950268819001845
[9]  Liu, H., Zhao, J., Xing, Y., et al. (2014) Nosocomial Infection in Adult Admissions with Hematological Malignancies Originating from Different Lineages: A Prospective Observational Study. PLoS ONE, 9, e113506.
https://doi.org/10.1371/journal.pone.0113506
[10]  Tatarelli, P. and Mikulska, M. (2016) Multidrug-Resistant Bacteria in Hematology Patients: Emerging Threats. Future Microbiology, 11, 767-780.
https://doi.org/10.2217/fmb-2015-0014
[11]  The, B.W., Harrison, S.J., Slavin, M.A., et al. (2017) Epidemiology of Bloodstream Infections in Patients with Myeloma Receiving Current Era Therapy. European Journal of Haematology, 98, 149-153.
https://doi.org/10.1111/ejh.12813
[12]  Chen, C.Y., Tien, F.M., Sheng, W.H., et al. (2017) Clinical and Microbiological Characteristics of Bloodstream Infections among Patients with Haematological Malignancies with and without Neutropenia at a Medical Centre in northern Taiwan, 2008-2013. International Journal of Antimicrobial Agents, 49, 272-281.
https://doi.org/10.1016/j.ijantimicag.2016.11.009
[13]  田磊, 王继军, 景红梅, 等. 恶性血液病患者合并血流感染的临床和病原学特征[J]. 中国感染与化疗杂志, 2017,17(5): 504-508.
[14]  中华医学会血液学分会, 中国医师协会血液科医师分会. 中国中性粒细胞缺乏伴发热患者抗菌药物临床应用指南(2016年版) [J]. 中华血液学杂志, 2016, 37(5): 353-359.
[15]  Liu, W.D., Shih, M.C., Chuang, Y.C., et al. (2019) Comparative Efficacy of Doripenem versus Meropenem for Hospital-Acquired and Ventilator-Associated Pneumonia. Journal of Microbiology, Immunology and Infection, 52, 788-795.
https://doi.org/10.1016/j.jmii.2019.04.008
[16]  Surveillance, C. (2020) Healthcare-Associated Infections and Antimicrobial Resistance in Canadian Acute Care Hospitals, 2014-2018. Canada Communicable Disease Report, 46, 99-112.
https://doi.org/10.14745/ccdr.v46i05a01
[17]  吴方强, 许夕海. 2014～2018年我院耐碳青霉烯类肺炎克雷伯菌分布特点及感染患者的临床特点[J]. 医学信息, 2019, 32(24): 28-31.
https://doi.org/10.3969/j.issn.1006-1959.2019.24.010
[18]  张国扬, 吴裕丹, 谢双锋, 等. 2012-2016年血液病患者血流感染病原菌分布及耐药性[J]. 中国感染控制杂志, 2018, 17(10): 853-859.
[19]  Huang, Y., Jiao, Y., Zhang, J., et al. (2018) Microbial Etiology and Prognostic Factors of Ventilator-Associated Pneumonia: A Multicenter Retrospective Study in Shanghai. Clinical Infectious Diseases, 67, S146-S152.
https://doi.org/10.1093/cid/ciy686
[20]  Thabit, A.K., Crandon, J.L. and Nicolau, D.P. (2015) Antimicrobial Resistance: Impact on Clinical and Economic Outcomes and the Need for New Antimicrobials. Expert Opinion on Pharmacotherapy, 16, 159-177.
https://doi.org/10.1517/14656566.2015.993381
[21]  Blennow, O. and Ljungman, P. (2016) The Challenge of Antibiotic Resistance in Haematology Patients. British Journal of Haematology, 172, 497-511.
https://doi.org/10.1111/bjh.13816
[22]  Carvalhaes, C.G., Shortridge, D., Sader, H.S. and Castanheira, M. (2020) Activity of Meropenem-Vaborbactam against Bacterial Isolates Causing Pneumonia in Patients in U.S. Hospitals during 2014 to 2018. Antimicrob Agents Chemother, 64, e02177-19.
https://doi.org/10.1128/AAC.02177-19
[23]  Meletis, G. (2016) Carbapenem Resistance: Overview of the Problem and Future Perspectives. Therapeutic Advances in Infectious Disease, 3, 15-21.
https://doi.org/10.1177/2049936115621709
[24]  Hu, F., Guo, Y., Yang ,Y., et al. (2019) Resistance Reported from China Antimicrobial Surveillance Network (CHINET) in 2018. European Journal of Clinical Microbiology & Infectious Diseases, 38, 2275-2281.
https://doi.org/10.1007/s10096-019-03673-1
[25]  Hu, F.P., Guo, Y., Zhu, D.M., et al. (2016) Resistance Trends among Clinical Isolates in China Reported from CHINET Surveillance of Bacterial Resistance, 2005-2014. Clinical Microbiology and Infection, 22, S9-S14.
https://doi.org/10.1016/j.cmi.2016.01.001
[26]  庄婧, 韦杰敏, 刘倍材, 等. 血液病患者粒细胞缺乏期革兰阴性菌血流感染的病原菌分布及药敏特点[J]. 广西医学, 2019, 41(23): 3023-3025+3032.
[27]  苗文娟, 林青松, 章萍. 血液病患者碳青霉烯类抗菌药物使用强度与病原菌耐药率的相关性分析[J]. 中国医药指南, 2018, 16(18): 153-154.
[28]  宋晓超, 杨海飞, 陈凯, 等. 2013-2018年恶性血液病患者血流感染病原菌与耐药性变迁[J]. 中华医院感染学杂志, 2018, 28(11): 1641-1644+1692.
https://doi.org/10.11816/cn.ni.2018-180941
[29]  Weiner, L.M., Webb, A.K., Limbago, B., et al. (2016) Antimicrobial-Resistant Pathogens Associated With Healthcare-Associated Infections: Summary of Data Reported to the National Healthcare Safety Network at the Centers for Disease Control and Prevention, 2011-2014. Infection Control & Hospital Epidemiology, 37, 1288-1301.
https://doi.org/10.1017/ice.2016.174
[30]  Gavriliu, L.C., Benea, O.E. and Benea, S. (2016) Antimicrobial Resistance Temporal Trend of Klebsiella pneumoniae Isolated from Blood. Journal of Medicine and Life, 9, 419-423.
[31]  Kolonen, A., Sinisalo, M., Huttunen, R., et al. (2017) Bloodstream Infections in Acute Myeloid Leukemia Patients treated According to the Finnish Leukemia Group AML-2003 Protocol—A Prospective Nationwide Study. Infectious Diseases, 49, 799-808.
https://doi.org/10.1080/23744235.2017.1347814
[32]  Trivedi, M., Patel, V., Soman, R., et al. (2012) The Outcome of Treating ESBL Infections with Carbapenems vs. Non Carbapenem Antimicrobials. Journal of the Association of Physicians of India, 60, 28-30.
[33]  Tamura, K., Akiyama, N., Kanda, Y., et al. (2015) Efficacy and Safety of Tazobactam/Piperacillin as an Empirical Treatment for the Patients of adult and Child with Febrile Neutropenia in Japan. Journal of Infection and Chemotherapy, 21, 654-662.
https://doi.org/10.1016/j.jiac.2015.05.009

Full-Text

Contact Us

service@oalib.com

QQ:3279437679

WhatsApp +8615387084133