Evaluation Of The Efficacy And Safety Of Vancomycin,Linezolid And Teicoplanin In The Treatment Of Pulmonary Infection With Multi-drug Resistant G~+ Bacteria

Objective:Investingate the distributeion of MDR Gram-positive bacteria in our hospital of Sputum Culture,analyzed the efficacy and safety of vancomycin,Linezolid and Teicoplanin for treatment of pulmonary infection caused by MDR Gram-positive bacteria.Methods:Collect data of Sputum culture results are MDR Gram-positive bacteria cases reported to the hospital of infection control department of the First Affiliated Hospital of Nanchang University from June 1 2017 to July 1 2019,According to the standard,devide them into three groups,the Vancomycin group,Linezolid group and Teicoplanin group.The clinical symptom,sign,bacterial clearance,treatment duration and side effects of all patients were recorded and analyzed to compare the treatment effect and adverse reaction of three drugs.Results:A total of 277 MDR Gram-positive bacteria were isolated from sputum culture in our hospital over the past two years.The top five were Staphylococcus aureus(65%),Streptococcus pneumoniae(12%),and Staphylococcus hemolyticus(accounting for 5%),Staphylococcus epidermidis(13.5%),Enterococcus faecium(13.5%).The male to female ratio is:1.6:1,and the majority of patients are over 50 years old.Among the departments,the top five are NICU(37%),neurosurgery(14%),rehabilitation department(13%),pediatrics(9%),and ELCU(8%).(2)A total of 89 cases were included,42 in the vancomycin group,27 in the linezolid group,and 20 in the teicoplanin group;the total effective rates of the three groups were 73.81%for vancomycin and 77.78%for linezolid,Teicoplanin 75.00%,bacterial clearance rates were vancomycin 50.00%,linezolid 51.85%,teicoplanin 45.00%,the incidence of adverse reactions were vancomycin 21.43%,linezolid 18.52%,replace Kolanin was 15.00%,and there was no statistical significance between the three groups(P>0.05);the duration of drug treatment in the three groups was vancomycin 12.33±10.08d,linezolid 12.89±8.41d,teicoplanin 12.59±9.87d,there was no statistically significant comparison between the three groups(P>0.05).Conclusion:This study shows that:(1)The department with the most of MDR Gram-positive bacteria in sputum culture of the First Affiliated Hospital of Nanchang University is NICU and the most common one is Staphylococcus aureus.(2)Vancomycin,Linezolid and Teicoplanin have the same clinical efficacy,bacterial clearance,treatment duration,and incidence of adverse reactions in the treatment of pulmonary MDR Gram-positive bacterial infections.All three can be used as in patient treatment The effective use of MDR gram-positive bacteria infection in the lung should be decided according to the specific situation of the patient when selecting drugs clinically.(3)In order to effectively control MDR Gram-positive bacteria infection in the lungs,it is necessary to strengthen monitoring and management measures in key departments,strictly implement protective measures,aseptic operation,avoid cross-infection,use medication reasonably,and reduce the risk of infection.