중환자실에서 발생하는 다제 내성 Acinetobacter baumannii에 의한 폐렴의 치료로서의 colistin과 carbapenem
Colistin and Carbapenem in the treatment of multidrug - resistant Acinetobacter baumannii pneumonias in the intensive care unit
i, 24 p.
다제 내성 Acinetobacter baumannii 폐렴 치료 colistin carbapenem;
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Abstract Introduction The nosocomial pneumonia due to Acinetobacter baumannii was increased, and was the most difficult pathogen to treat, because we had limiting regimens. Objective To evaluate the effect of colitin with carbapenem for suspected ventilator-associated pneumonia by carbapenem resistant A. baumannii in the ICU, and to evaluate the predictors of adverse outcomes. Methods The study included 187 mechanically ventilated patients of more than 48 hours, who developed suspected ventilator associated pneumonia (VAP) in 52 beds of the ICU of a teaching hospital in South Korea. We retrospectively analyzed 66 patients with A. baumannii pneumonia. Results 55 patients had carbapenem-resistant A. baumannii (CRAB) pneumonia, and 11 patients had carbapenem-susceptible A. baumannii (CSAB) pneumonia. There was no difference in the baseline characteristics of both groups. Clinical responses were observed in 54.5% of the CRAB pneumonia patients, and in 63.6% of the CSAB pneumonia patients (p=0.74). The adequacy of antimicrobials in CSAB pneumonia was higher than in CRAB pneumonia (90.9% vs 41.8%, p=0.08). But there was no significant difference of 28-day mortality in CSAB and CRAB pneumonia (27.3% vs 41.8%, p=0.5). The 28-day mortality of 25 CRAB pneumonia who had clinical failure was 76%, which was significantly higher than the CRAB pneumonia patients who had clinical response (76% vs 13.3%, p