耐亚胺培南鲍曼不动杆菌对3种舒巴坦复合剂耐药性的meta分析

目的采用meta分析对现已发表的氨苄西林／舒巴坦、头孢哌酮／舒巴坦和哌拉西林／舒巴坦治疗耐亚胺培南鲍曼不动杆菌（IRAB）的文献进行综合分析，科学比较哪种抗生素的治疗效果更好。方法全面收集IRAB对氨苄西林／舒巴坦、头孢哌酮／舒巴坦和哌拉西林／舒巴坦耐药性研究的资料，根据严格的标准筛选纳入文献，用RevMan4．2软件进行meta分析。结果共有9篇文献符合纳入标准。对氨苄西林／舒巴坦和头孢哌酮／舒巴坦的耐药性分析表明，IRAB对氨苄西林／舒巴坦（62．8％）的耐药性显著高于对头孢哌酮／舒巴坦的（44．7％）（P〈0．001）。对氨苄西林／舒巴坦和哌拉西林／舒巴坦的耐药性分析表明，IRAB对氨苄西林／舒巴坦（70．7％）的耐药性显著低于对哌拉西林／舒巴坦的（95．2％）（P〈0．001）。综合可得，IRAB对头孢哌酮／舒巴坦的耐药性最弱，对哌拉西林／舒巴坦的耐药性最强。结论在IRAB的治疗中，头孢哌酮／舒巴坦的敏感性高于氨苄西林／舒巴坦和哌拉西林／舒巴坦，是较好的供选抗生素。

Comparison of Activities of Three Sulbactam Complex Against Imipenem Resistant Acinetobacter Baumannii Infections: A Meta Analysis

OBJECTIVE A meta analysis was performed to decide whether ampicillin, cefoperazone or piperacillin in combination with sulbactam is better to cure imipenem resistant Acinetobacter baumannii in China. METHODS After a comprehensive electronic and manual searching according to our strict criterions, the related data were used for subsequent meta analysis using RevMan 4.2. RESULTS Total 9 papers were collected. The resistant rate of IRAB versus ampicillin/sulbactam (62.8%) was significantly higher than that of cefoperazone/sulbactam (44.7%) (P<0.001), and the resistant rate of IRAB versus ampicillin/sulbactam (70.7%) was significantly lower than that of piperacillin/sulbactam (95.2%) (P<0.001). That is to say, among the three sulbactam complex the resistant rate of IRAB versus cefoperazone/sulbactam was the highest, while the resistant rate of IRAB versus piperacillin /sulbactam was the lowest.CONCLUSION In the process of curing IRAB infections, cefoperazone/sulbactam is more sensitive than ampicillin/sulbactam and piperacillin/sulbactam, and thus is a better candidated antibiotic.