利奈唑胺治疗老年心功能不全革兰阳性球菌感染患者的临床分析

目的:总结分析利奈唑胺治疗革兰阳性球菌感染的老年心功能不全患者的临床疗效及安全性。方法:回顾分析4家医院2009年1月-2011年1月收治的使用利奈唑胺治疗的革兰阳性球菌感染的35例心功能不全老年患者的临床资料。结果:全部患者均检出革兰阳性菌株,25例感染部位为肺,10例为血液,利奈唑胺治疗后总有效率为82.9%,有效时间为3～10d,有24例直接使用利奈唑胺治疗,用药后清除21例(87.5%),11例为万古霉素无效或不能耐受后换用利奈唑胺治疗,用药后清除8例(72.7%),共6例出现不良反应,3例皮疹,2例血小板减少,1例腹泻,全部患者都能够耐受。结论:利奈唑胺治疗革兰阳性球菌感染的老年心功能不全患者疗效确切、安全,可一线应用于抗革兰阳性球菌感染治疗或万古霉素治疗无效时换用利奈唑胺。

Clinical analysis of linezolid treatment for elderly heart failure patients with Gram-positive bacterial infections

OBJECTIVE To analyze the efficacy and safety of linezolid treatment for Gram-positive bacterial infections in elderly heart failure patients.METHODS Retrospective analysis:35 cases of four hospitals in January 2009-January 2011 were giventreated with linezolid treatment for Gram-positive bacterial infections with heart failure in elderly patients.RESULTS Gram-positive bacterial infections were detected in all the patients:25 cases of infection of the lung,10 cases of blood.The total effective rate was 82.9%,the effective time was 3-10 d.24 cases were directly administered linezolid treatment,the bacterial elimination was found in 21 cases(87.5%);11 cases were treated with vancomycin ineffectively or not be tolerated and then changed with the treatment of linezolid,among which the bacterial elimination was found in 8 cases(72.7%).Adverse reactions were discovered in 6 cases:3 cases rash,2 cases of thrombocytopenia,one case of diarrhea;all patients can tolerate the treatment of linezolid.CONCLUSION The treatment of linezolid for Gram-positive bacterial infections in elderly heart failure patients is effective and safety,it can be applied asto first-line therapy for Gramanti-gram-positive bacterial infections treatment or in case of ineffective treatment of vancomycin.