Clinical analysis of Eravacycline in the treatment of patients with severe immunosuppression combined with Carbapenem-resistant Acinetobacter baumannii pneumonia

doi:10.3877/cma.j.issn.2096-1537.2024.03.18-0001

Abstract

Abstract:

Objective

To investigate the efficacy and safety of Eravacycline in the treatment of severe immunosuppression complicated with Carbapenem-resistant Acinetobacter baumannii (CRAB) pneumonia.

Methods

The clinical data of 3 patients with severe neurological conditions admitted to Department of Neurology ICU of the First Affiliated Hospital of Sun Yat-sen University from July 2023 to December 2023 were retrospectively analyzed. They were treated with immunosuppressants due to the primary disease and subsequently combined with CRAB pneumonia. Clinical characteristics, biochemical indexes, bacterial culture and drug sensitivity test results, antibacterial drug types, imaging data before and after treatment and APACHE Ⅱ score of patients were collected to evaluate clinical efficacy and adverse drug reactions of patients.

Results

Among the 3 patients, 1 was female and 2 were male, aged 52-60 years. Acinetobacter baumannii was detected in alveolar lavage fluid, sputum and pharyngeal swab samples, and drug sensitivity test indicated Carbapenem antibiotic resistance. After treatment with Eravacycline, APACHE II scores, clinical manifestations, inflammatory indicators, and imaging examinations were significantly improved. No adverse reactions associated with Eravacycline were found.

Conclusion

Eravacycline has good efficacy and safety in the treatment of pneumonia caused by CRAB.

Key words: Carbapenem-resistant Acinetobacter baumannii, Multidrug-resistant bacteria infect pneumonia, Elacycline

Jia Chang, Rong Lai, Kang Liao, Li Feng, Xunsha Sun, Huiyu Feng, Hongyan Zhou. Clinical analysis of Eravacycline in the treatment of patients with severe immunosuppression combined with Carbapenem-resistant Acinetobacter baumannii pneumonia[J]. Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition), doi: 10.3877/cma.j.issn.2096-1537.2024.03.18-0001.

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URL: https://icu.cma-cmc.com.cn/EN/10.3877/cma.j.issn.2096-1537.2024.03.18-0001

Figures/Tables 4

References 20

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抗生素	1号菌	2号菌	3号菌
黏菌素	≤0.5（S）	≤0.5（S）	≤0.5（S）
替加环素	4（I）	1（S）	2（S）
米诺环素	8（I）	4（I）	8（I）
依拉环素	0.125（S）	-	0.25（S）
亚胺培南	≥16（R）	≥16（R）	≥16（R）
美罗培南	≥16（R）	≥16（R）	≥16（R）

抗生素	1号菌	2号菌	3号菌
黏菌素	≤0.5（S）	≤0.5（S）	≤0.5（S）
替加环素	4（I）	1（S）	2（S）
米诺环素	8（I）	4（I）	8（I）
依拉环素	0.125（S）	-	0.25（S）
亚胺培南	≥16（R）	≥16（R）	≥16（R）
美罗培南	≥16（R）	≥16（R）	≥16（R）

患者		CRP（mg/L）	PCT（ng/dl）	WBC（×10⁹/L）	NEUT%	NEUT#（×10⁹/L）	APACHEⅡ评分	氧合指数（mmHg）
病例1	治疗前	103.78	80	12.19	94	17.70	18	190
	治疗后	48.20	54	10.52	77	8.06	16	245
病例2	治疗前	62.60	105	8.02	90	10.36	17	220
	治疗后	4.23	19	6.33	91	6.08	14	260
病例3	治疗前	17.89	21	9.29	94	6.34	10	182
	治疗后	6.10	6	5.87	88	5.32	3	310

患者		CRP（mg/L）	PCT（ng/dl）	WBC（×10⁹/L）	NEUT%	NEUT#（×10⁹/L）	APACHEⅡ评分	氧合指数（mmHg）
病例1	治疗前	103.78	80	12.19	94	17.70	18	190
	治疗后	48.20	54	10.52	77	8.06	16	245
病例2	治疗前	62.60	105	8.02	90	10.36	17	220
	治疗后	4.23	19	6.33	91	6.08	14	260
病例3	治疗前	17.89	21	9.29	94	6.34	10	182
	治疗后	6.10	6	5.87	88	5.32	3	310

患者		肝功能				肾功能
患者		ALT（U/L）	AST（U/L）	r-GGT（U/L）	总胆红素（μmol/L）	BUN（mmol/L）	Cr（μmol/L）
病例1	治疗前	24	39	123	9.2	13.2	12
	治疗后	47	58	118	8.1	14.1	16
病例2	治疗前	209	274	117	15.1	13.7	50
	治疗后	187	64	164	10.5	10.6	32
病例3	治疗前	40	57	96	17.2	10.6	29
	治疗后	93	106	174	10.9	9.2	19

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