| Objective: To further study the therapeutic effect of Tigecycline combined with Cefoperazone Sodium and Sulbactam Sodium for Injection on the patients who got the Carbapenem-resistant Acinetobacter baumannii,analyze the clinical characteristics of patients with pneumonia caused by Carbapenem-resistant Acinetobacter baumannii,and factors affecting the prognosis of patients,so as to provide scientific evidence for clinical physicians to choose the optimum treatment method,improve the prognosis of patients,and reduce the irrational use of antibiotics.Methods: This study collected 108 patients with pneumonia caused by Carbapenem-resistant Acinetobacter baumannii in Wuhu Second People’s Hospital affiliated to East China Normal University from January 2017 to December 2022.After browsing the electronic medical record,we divided the patients who used tigecycline combined with Cefoperazone Sodium and Sulbactam Sodium for Injection into the experimental groups,and divided the patients treated with Cefoperazone Sodium and Sulbactam Sodium for Injection combined with other antibiotics into the control groups.We would like to explore the therapeutic effects of different schemes.Then,according to the clinical outcome of the patients,they were also divided this patients into the clinical improvement group and the non-improvement group.And we planned to investigate and statistically describe the clinical characteristics of the patients between the two groups.At the same time,Logistic regressive analysis was performed on the variables with p<0.05 to calculate the factors related to clinical improvement.Results:(1)In the comparison of case data between the experimental group and the control group,we found that the difference in Apache II score between this two groups was statistically significant(19.88±5.340 vs.17.67±5.796,p=0.043,p<0.05).(2) There was a difference between the experimental group and the control group in whether or not they died in hospital(27/50,54% vs.19/58,32.76%,p=0.026,p<0.05) and the 28-day all-cause death(17/50,34% vs.10/58,17.24%,p=0.045,p<0.05),too. However,the difference between the two groups in 14-day all-cause mortality was not statistically significant(9/50,18% vs 5/58,8.62%,p=0.148).(3)The analysis results also showed that there was no statistically significant difference between the age(76 years old,IQR58-81 vs 72 years old,IQR61.5-78.5,p=0.629),gender(24/39,61.54% vs 51/69,73.91%,p=0.180),use time of ventilator(22 days,IQR13-37 vs 20 days,IQR9-46,p=0.948),Apache II score(18.82±4.989 vs.18.62±0.059,p=0.863)and basic disease in the improved and non-improved group after the clinical treatment(p>0.05).The diagnosis of shock(14/39,35.90% vs 13/69,18.84%,p=0.049),the duration of hospitalization(45 days,IQR27-82 vs 67 days,IQR39-97.5,p=0.046),the use time of antibiotics(9.72±3.713 days vs 13 days,IQR9-15,p=0.003),and the White Blood Cells returned to the normal range after the treatment(14/24,58.33% vs 54/66,81.81%,p=0.022)were statistically significant differences between the two groups.(4) Taking whether the patients infected with Carbapenem-resistant Acinetobacter baumannii improved after 14 days of treatment as the dependent variable,and taking the patient’s duration of hospitalization,the use time of antibiotics,whether the White Blood Cells fell back to the normal range after the treatment,shock and the antibiotics treatment plan as the possible influencing factors,Logistic regressive analysis was carried out.The results showed that the use time of antibiotics and the existence of White Blood Cells difference were independent factors promoting the rehabilitation of clinical treatment of patients(p>0.05),but there was no significant difference between the duration of hospitalizationy,the diagnosis of shock and the type of antibiotics and the clinical outcome of patients infected with Carbapenem-resistant Acinetobacter baumannii(p>0.05).Conclusion: Patients who had been infected with Carbapenem-resistant Acinetobacter baumannii and with a higher Apache II score are more likely to use tigecyclin combined with Cefoperazone Sodium and Sulbactam Sodium for Injection for treatment,which may shortly prolong their survival time,but does not change their mortality.Tigecycline combined with Cefoperazone Sodium and Sulbactam Sodium for Injection could not promote the 14-day microbial clearance of Carbapenem-resistant Acinetobacter baumannii.The prolonged use of antibiotics is beneficial to the rehabilitation of patients infected with Carbapenem-resistant Acinetobacter baumannii.It is recommended to use antibiotics for 14 days or more.And we also suggest reviewing the blood routine examination in time and observe whether the White Blood Cells fall back to the normal range,which is beneficial to reduce the unnecessary use of antibiotics and improve the patient’s condition. |
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