背景:耐碳青霉烯类鲍曼不动杆菌(CRAB)肺炎与不良的临床预后和增加的死亡率相关。关于CRAB最佳治疗的临床数据有限,和联合治疗通常是首选。埃拉伐环素已证明了抗鲍曼不动杆菌的体外活性,并已被考虑用于治疗由CRAB引起的肺部感染。
目的:本病例系列的目的是描述在县医院作为联合方案治疗CRAB肺炎的一部分使用埃拉环素的相关临床结果。
方法:从2020年4月1日至2020年10月1日进行了回顾性图表审查,其中包括年龄≥18岁的住院患者,诊断为2019年冠状病毒病(COVID-19),痰培养CRAB阳性,并接受至少一剂埃拉环素。研究的主要结果是CRAB肺炎的临床消退。一个关键的次要结果是微生物学分辨率。
结果:共有24例患者接受了埃拉环素联合治疗,中位时间为10.5天。总的来说,17例(71%)患者表示出CRAB肺炎的临床消退。收集17例(71%)患者治疗后重复痰培养,其中12人(71%)达到了微生物分辨率。未发现可归因于埃拉环素的不良事件。
结论:可行的抢救治疗方案有限,埃拉环素联合治疗对CRAB肺炎患者显示良好的微生物学和临床结局.鉴于此,在设计CRAB肺炎抢救治疗方案时,埃拉环素可被视为一种潜在的治疗选择.
BACKGROUND: Carbapenem-resistant Acinetobacter baumannii (CRAB) pneumonia is associated with poor clinical outcomes and increased mortality. Clinical data regarding the optimal treatment of CRAB is limited, and combination therapy is often preferred. Eravacycline has demonstrated in-vitro activity against A. baumannii and has been considered for the treatment of pulmonary infections caused by CRAB.
OBJECTIVE: The objective of this
case series was to describe clinical outcomes associated with eravacycline when utilized as part of a combination regimen for the treatment of CRAB pneumonia at a county hospital.
METHODS: A retrospective chart review was conducted from April 1, 2020, to October 1, 2020, which included hospitalized patients ≥18 years of age, diagnosed with coronavirus disease 2019 (COVID-19), with a sputum culture positive for CRAB, and receipt of at least one dose of eravacycline. The primary outcome studied was clinical resolution of CRAB pneumonia. A key secondary outcome was microbiological resolution.
RESULTS: A total of 24 patients received combination eravacycline therapy for a median of 10.5 days. Overall, 17 (71%) patients demonstrated clinical resolution of CRAB pneumonia. Repeat sputum cultures post-treatment were collected in 17 (71%) patients, of which 12 (71%) achieved microbiological resolution. No adverse events attributable to eravacycline were identified.
CONCLUSIONS: With limited viable salvage treatment options, combination eravacycline therapy showed favorable microbiological and clinical outcomes in patients with CRAB pneumonia. In light of this, eravacycline could be considered as a potential treatment option when designing CRAB pneumonia salvage therapy regimens.