Acinetobacter baumannii Ventilator-Associated Pneumonia: Clinical Efficacy of Combined Antimicrobial Therapy and in vitro Drug Sensitivity Test Results

作者：Yuqin Huang, Quan Zhou, Wenguo Wang, Qiang Huang, Juan Liao, Junyi Li, Lei Long, Tao Ju, Quan Zhang, Hanqin Wang, Huaqiang Xu, TU Ming-li · 发表于：Frontiers in Pharmacology · 年份：2019 · DOI：10.3389/fphar.2019.00092 · 被引用次数：47 · 研究领域：Antibiotic Resistance in Bacteria、Nosocomial Infections in ICU、Antibiotic Use and Resistance

Objective: To evaluate therapeutic efficacy of different combined antimicrobial treatments against acinetobacter baumannii ventilator-associated pneumonia (VAP). Methods: Clinical outcomes were retrospectively analyzed to elucidate the efficacy of four combined antimicrobial regimens. The chessboard and micro broth dilution methods determined the minimum inhibitory concentrations of four antiseptic drugs singly used and combined two drugs against 36 isolates of multi-drug resistant (MDR) acinetobacter baumannii. Results: The incidence of VAP was approximately 6.9% (237/3424) between January 1 2015 and December 31, and 35.9% (85/237) of the cases were caused by acinetobacter baumannii. Among these cases, 60 belonged to AB-VAP, for whom antimicrobial treatment plan was centralized and clinical data was complete. Moreover, all 60 strains of acinetobacter baumannii were MDR bacteria from reports microbiological laboratory. Resistance rate was lowest for amikacin (68.3%) and ampicillin sulbactam (71.7%). Resistance rate for imipenem increased from 63.2% to 90.9% during the three years. However, in these 60 cases of AB-VAP, the combination between 4 antibiotics was effective in most cases: the effective rate was 75%(18/24) for sulbactam combined with etilmicin, 71.4%(10/14) for sulbactam combined with levofloxacin, 72.7%(8/11) for meropenem combined with etilmicin, and 63.6%(7/11) for meropenem combined with levofloxacin. There was no statistical difference between four regimens(P>...