Del Pozo J L, García Cenoz M, Hernáez S, Martínez A, Serrera A, Aguinaga A, Alonso M, Leiva J
Division of Infectious Diseases, Clínica Universidad de Navarra, Pamplona, Spain.
Int J Antimicrob Agents. 2009 Nov;34(5):482-5. doi: 10.1016/j.ijantimicag.2009.06.020. Epub 2009 Aug 26.
The aim of this study was to analyse the effectiveness of teicoplanin versus vancomycin lock therapy in the treatment of coagulase-negative staphylococci (CoNS) venous access port-related bloodstream infection (BSI). The study included 44 consecutive patients during a 36-month prospective case-series study. The primary endpoint was failure to cure. Treatment was successful in 39 patients. At the end of the study, the cumulative port survival rate was 100% in the teicoplanin lock group compared with 77% in the vancomycin lock group (P=0.06). In the Cox regression analysis, fever beyond 48 h of treatment was a significant predictor of treatment failure (P=0.02). Use of vancomycin or teicoplanin locks had an effectiveness of 88.6% in the treatment of CoNS port-related BSI. Teicoplanin locks reduced the failure rate from 18.5% to 0% compared with vancomycin locks. The presence of fever after beginning antimicrobial lock therapy was associated with treatment failure.
本研究旨在分析替考拉宁与万古霉素封管疗法治疗凝固酶阴性葡萄球菌（CoNS）所致静脉输液港相关血流感染（BSI）的有效性。在一项为期36个月的前瞻性病例系列研究中纳入了44例连续患者。主要终点为治疗未愈。39例患者治疗成功。研究结束时，替考拉宁封管组的输液港累积生存率为100%，而万古霉素封管组为77%（P=0.06）。在Cox回归分析中，治疗48小时后仍发热是治疗失败的显著预测因素（P=0.02）。使用万古霉素或替考拉宁封管治疗CoNS输液港相关BSI的有效率为88.6%。与万古霉素封管相比，替考拉宁封管使失败率从18.5%降至0%。抗菌封管治疗开始后出现发热与治疗失败相关。
