1.Clinical therapeutic effect of tigecycline combined with cefoperazone/sulbactam on treatment of multiple drug resistant strains and pandrug-resistant acinetobacter baumannii infection
Huiling ZANG ; Shengchi WANG ; Hui CHENG ; Lizhong WANG ; Shaoqing LIANG
Clinical Medicine of China 2016;32(1):41-43
Objective To explore the efficacy of tigecycline combined with cefoperazone/sulbactam in the treatment of infections due to multiple drug resistant strains and pandrug-resistant acinetobacter baumannii, so as to guide the reasonable clinical medication.Methods A total of 16 cases of ventilator associated pneumonia caused by multiple drug resistant strains and pandrug-resistant acinetobacter baumannii treated in the First Hospital of Shijiazhuang from November 2012 to November 2014 were retrospectively analyzed, and the severity of the infection, clinical efficacy and mortality were observed.Results The multiple drug resistant strains and pandrugresistant acinetobacter baumannii were frequently detected in the 16 patients.Fifteen cases had been used other antibiotics before tigecycline, such as imipenem, cefoperazone/Shubatan, minocycline etc.The severity of underlying disease was assessed with the acute physiology and chronic health score(APACHE Ⅱ sore) within 24 h of admission, on the first day of tigecycline (TGC) therapy and after 7 days of TGC therapy.It showed that the average APACHE Ⅱ score were (25±6.0), (24.2±6.4) and (17.8±6.6) within 24 hours of admission(P<0.01), on the first day of TGC therapy and after 7 days of TGC therapy.Thirty days after application of the TGC, the bacterial eradication rate was 56.25% (9/16).The effective rate was 87.5% (14/16).The failure rate was 12.5% (2/16).Conclusion The effect of the tigecycline combined with cefoperazone/sulbactam on the clearance of the multiple drug resistant strains and pandrug-resistant acinetobacter baumanniiis is satisfied.
2.Diagnosis and treatment of novelcoronavirus pneumonia after kidney transplant: a report of 2 cases
Xiaoxu MA ; Suhua ZANG ; Weili CHU ; Aiguo XU ; Mengying YAO ; Dongmei JIANG ; Huiling LI ; Qingxian ZHANG ; Lihua XING
Chinese Journal of Organ Transplantation 2020;41(4):207-211
Objective:To explore the clinical features and managements of novel coronavirus (2019-nCoV) infection after kidney transplantation.Methods:The authors reviewed medical history, laboratory values, imaging studies, treatment options and clinical outcomes of two confirmed hospitalized cases of COVID-19 after kidney transplant in February 2020. Both cases were middle-aged males and confirmed as COVID-19 at 11 or 12 months after transplantation. They both presented initially with moderate-to-low fever, cough and fatigue. Chest computed tomography (CT) hinted at multiple peripheral patchy ground glass opacities or patchy exudation and in bilateral multiple lobular and subsegmental with obscure boundary. Both had varying degrees of renal function and cardiac insufficiency.Results:In case 1, the dose of immunosuppressants was tapered while a higher dose of glucocorticoids was prescribed during treatment. In case 2, the dose of immunosuppressants was not tapered and continuous renal replacement therapy (CRRT) performed thrice in the early disease course due to renal insufficiency and hyperkalemia. Both cases received oxygen inhalation, lopinavir/ritonavir, oral abidor and interferonα-2b antiviral therapy, antibiotics treatment. Both cases were cured.Conclusions:The clinical manifestations and diagnosis of COVID-19 patients after kidney transplantation are not significantly different from those of other people. However, early renal function and heart function abnormalities occur. How to adjust the immunosuppressant in the treatment course of severe COVID-19 after renal transplantation should be further explored.