Difference in resistance risk of Pseudomonas aeruginosa from sputum of patients with mechanical ventilation and imipenem/cilastatin and meropenem treatment
10.3969/j.issn.1671-9638.2016.06.008
- VernacularTitle:亚胺培南／西司他丁和美罗培南治疗机械通气患者痰分离铜绿假单胞菌的耐药风险差异
- Author:
Guojie TENG
;
Xiuhong NIE
;
Qiang YANG
- Publication Type:Journal Article
- Keywords:
Pseudomonas aeruginosa;
drug resistance;
drug resistance,microbial;
imipenem/cilastatin;
meropenem;
rational antimicrobial use
- From:
Chinese Journal of Infection Control
2016;15(6):397-400,404
- CountryChina
- Language:Chinese
-
Abstract:
Objective To understand antimicrobial resistance and therapeutic efficacy of imipenem/cilastatin and meropenem for treatment of multidrug-resistant Pseudomonas aeruginosa (MDRPA)from patients with mechanical ventilation.Methods From January 2010 to December 2015,78 patients with mechanical ventilation and isolated MDRPA from sputum cultures were selected and divided into imipenem/cilastatin (n=44)and meropenem(n=34) treatment groups,basic condition,time of emergence of drug resistance,and therapeutic efficacy of antimicrobial agents between two groups were compared.Results The basic data of two groups were comparable,before treat-ment by imipenem/cilastatin and meropenem,resistance rates of Pseudomonas aeruginosa (P .aeruginosa )to quinolones,ceftazidime,piperacillin,and amikacin were not significantly different (all P >0.05).After patients received antimicrobial agents for 6 days,difference in antimicrobial resistance between imipenem /cilastatin and meropenem treatment groups were not significantly different (22.73% vs 8.82%,P >0.05).On the 8th,10th,and 12th day of treatment,resistance rates of imipenem treatment group were 40.91%,77.27%,and 97.73%, respectively,which were all higher than meropenem treatment group (17.65%,32.35%,44.12%,respectively,all P <0.05).After the treatment with different antimicrobial agents,the average time for the emergence of resistance in imipenem/cilastatin and meropenem treatment group were 9.0 days and 13.5 days respectively.Therapeutic efficacy between two groups was not significantly different (64.71% vs 74.19%,P =0.41).Conclusion Compared with meropenem,imipenem/cilastatin shows higher risk for the emergence of drug resistance during therapy of P . aeruginosa infection in patients with mechanical ventilation,there is no significant difference in therapeutic efficacy between two groups of patients after 7 days of treatment.
