A Study On The Efficacy Of Tigecycline In Patients With Multidrug-resistant Bacteria Lung Infections

Objective:This study was aimed to observe the clinical curative effect of tigecycline in multiple drug-resistant bacteria lung infections by retrospective observation,and provide evidence for reasonable treatment in the control of multiple drug-resistant bacteria lung infections.Method:By collecting datas of patients,which admittde to the Second Affiliated Hospital of Nanchang University from January 2013 to July 2016,the diagnosis of pulmonary infection,more than two bacterial culture prompted multiple resistant Gram-negative bacilli infection(excluding Pseudomonas aeruginosa),the use of tigecycline treatment for more than 5 days of patients,We analyzed the efficacy of both clinical and etiology and analyzed the datas using SPSS 22.0 software.Results:1.92 patients were enrolled in the study,including 73 cases of male patients,the average time of administration was 9.7±4.3days.2.After treatment,the patient’s body temperature showed a downward trend.The mean temperature of the 3rd day,the 5th day and the 7th day were lower than the mean temperature of the first day after the administration,and the P value was less than 0.05,the difference was statistically significant.The comparisons of four groups of data including WBC,N%,CRP and PCT showed a downward trend after treatment,and the P values were less than 0.05,the difference was statistically significant.The WBC=10×109/L,N%=70%,CRP=10mg/L,PCT=0.5ug/L as the cut-off point,compared the rate of inflammation to normal after administration,VAP subgroup was lower than HAP Subgroup,but the difference was not statistically significant.The sensitivity of PCT in the diagnosis of pneumonia was assessed by PCT=0.5ug/L as the cut-off point.The VAP subgroup(81.7%)was higher than the HAP subgroup(57.9%),P<0.05,the difference was statistically significant.3.The total clinical efficacy was 47.8% in 92 patients.All subgroups clinical efficacy: CAP group was 100% and HAP was higher than VAP group(63.2% VS 42.3%,P=0.10),the difference was not statistically significant;The old age group ≥75 years(38.5%)were lower than those in the age group <75 years(38.5% VS 51.5%,P=0.26),the difference was not statistically significant;The clinical efficacy with APACHE Ⅱ score ≤ 15 was higher than those with APACHE Ⅱ score>15(54.2% VS 28.0%),P<0.05,the difference was statistically significant;Patients with renal function in normal subgroup were higher than those in renal dysfunction group(55.6% vs 31.0%),P<0.05,the difference was statistically significant.The normal subgroup of liver function and the subgroup of patients without hypoproteinemia were higher than those of liver function and hypoalbuminemia,the difference was not statistically significant.4.257 strains of resistant bacteria were isolated before the administration of tigecycline,and the overall pathogen clearance rate was 67.4%.The primary isolated pathogens were MDRAB(multi-drug resistant Acinetobacter baumannii)(56.8%),and the pathogen clearance rate was 58.7%.Most strains were susceptible to tigecycline.18.5% of patients died during hospitalization.Conclusions:1.Tigecycline has a certain effect for the treatment of lung infection caused by multiple drug-resistant bacteria or pan-resistant bacteria,In the absence of polymyxin anti-infective drugs to choose from the case,tigecycline-based joint antibacterial program is still a good choice.2.High APACHE Ⅱ score and renal impairment have an effect on the clinical efficacy of tigecycline.