Nakamura T, Ushiyama C, Suzuki Y, Inoue T, Shoji H, Shimada N, Koide H
Department of Medicine, Misato Junshin Hospital, Saitama, Japan.
J Hosp Infect. 2003 Jan;53(1):58-63. doi: 10.1053/jhin.2002.1332.
The aim of the present study was to determine whether treatment with polymyxin B-immobilized fibre (PMX-F) haemoperfusion, teicoplanin, or both in combination is effective in patients with methicillin-resistant Staphylococcus aureus (MRSA) sepsis. Sixty patients with MRSA sepsis were randomly assigned to one of four treatments: (A) PMX-F treatment (N=15), (B) teicoplanin treatment (N=15), (C) PMX-F and teicoplanin in combination (N=20) and (D) conventional therapy (N=10). PMX-F treatment was repeated twice. Teicoplanin was administered by intravenous injection. Plasma endotoxin levels were determined by endospecy test. Plasma endotoxin levels were reduced in groups A and C (P<0.05). Survival rates were 53, 47, 90, and 20% in groups A, B, C and D, respectively (group C versus group A, P<0.05; group C versus group B, P<0.01; group C versus group D,P <0.001). The mean duration of stay was 44, 42, 28 and 56 days in groups A, B, C and D, respectively. Our data suggest that combination therapy with PMX-F and teicoplanin is effective for sepsis caused by MRSA.
本研究的目的是确定用多粘菌素B固定化纤维（PMX-F）血液灌流、替考拉宁或两者联合治疗对耐甲氧西林金黄色葡萄球菌（MRSA）败血症患者是否有效。60例MRSA败血症患者被随机分配到四种治疗组之一：（A）PMX-F治疗组（N = 15），（B）替考拉宁治疗组（N = 15），（C）PMX-F与替考拉宁联合治疗组（N = 20）和（D）传统治疗组（N = 10）。PMX-F治疗重复两次。替考拉宁通过静脉注射给药。通过内毒素检测测定血浆内毒素水平。A组和C组的血浆内毒素水平降低（P<0.05）。A、B、C和D组的生存率分别为53%、47%、90%和20%（C组与A组相比，P<0.05；C组与B组相比，P<0.01；C组与D组相比，P<0.001）。A、B、C和D组的平均住院时间分别为44天、42天、28天和56天。我们的数据表明，PMX-F与替考拉宁联合治疗对MRSA引起的败血症有效。
