头孢他啶/阿维巴坦钠治疗肝移植术后CRKP感染的临床回顾性研究

摘要：目的 探讨头孢他啶/阿维巴坦钠治疗肝移植术后耐碳青霉烯肺炎克雷伯菌(CRKP)感染的临床疗效，为肝移植术 后患者抗感染治疗提供理论依据。方法 回顾性分析2019年8月—2020年3月肝移植术后确诊耐碳青霉烯类肺炎克雷伯菌感 染的11例患者临床资料。统计分析感染部位、肝移植手术时间、首次使用头孢他啶/阿维巴坦钠时间、平均用药时间、临床 转归以及不良反应。结果 肝移植术后CRKP感染部位主要为呼吸道、腹腔、血液和胆道，术后至首次用药平均间隔时间为 (275.27±364.30)d，中位时间96d，头孢他啶/阿维巴坦钠平均用药时间数为(24.0±12.3)d，中位时间24d。MDR-CRKP临床治愈 率83.33%，XDR-CRKP临床治愈率60.0%，不良反应较轻。结论 头孢他啶/阿维巴坦钠可用于治疗肝移植术后CRKP感染。

Retrospective analysis of ceftazidime/avibactam in patients with carbapenemresistant Klebsiella pneumoniae infection after liver transplantation

Abstract Objective To investigate the anti-infection effects of ceftazidime/avibactam in patients with carbapenem-resistant Klebsiella pneumoniae (CRKP) infection after liver transplantation and to provide theoretical basis for the anti-infection treatment of patients after liver transplantation. Methods The clinical data of 14 patients with carbapenem-resistant Klebsiella pneumoniae after liver transplantation from August 2019 to March 2020 were analyzed retrospectively. The site of infection, the time of liver transplantation, the time of first use of ceftazidime/ avibactam, the average days of drug use, clinical outcome and adverse reactions were analyzed. Results The infection sites of CRKP after liver transplantation were mainly in the respiratory tract, the abdominal cavity, the blood and biliary tract. The mean time between the operation and the first administration was (275.27±364.30) days, and the median time was 96 days. The mean time of ceftazidime/avibactam administration was (24.0±12.3) days, and the median length of therapy was 24 days. The clinical cure rate of MDR-CRKP and XDR-CRKP were 83.33% and 60.0% respectively. The adverse reactions were mild. Conclusion Ceftazidime/avibactam can be used in the treatment of CRKP infection after liver transplantation.