Department of Anaesthesiology and Intensive Therapy, Semmelweis University, 1082 Üllői út 78, Budapest, Hungary.
Sci Rep. 2022 Mar 15;12(1):4455. doi: 10.1038/s41598-022-08307-9.
Resistant strains of Pseudomonas aeruginosa are common pathogens in the intensive care unit (ICU), limiting available therapeutic options. We aimed to compare ceftolozane/tazobactam (C/T) with colistimethate sodium (CMS) in the treatment of ventilator-associated pneumonia (VAP) due to extensively drug-resistant (XDR) Pseudomonas aeruginosa. A retrospective, observational study was performed at a tertiary care ICU. Clinical and microbiological success rate, 28-day all-cause mortality, and adverse events were compared in patients who received C/T with those treated with systemic CMS. A total of 51 patients were included (18 in the C/T and 33 in the CMS group). Clinical success rates in the C/T and CMS groups were 13 (72.2%) and 10 (30.3%), respectively. On multivariate regression analysis, treatment with C/T was independently associated with clinical success (odds ratio 4.47, 95% CI 1.17-17.08). There was no difference in 28-day all-cause mortality (27.8% and 33.3% in the C/T and CMS group, p = 0.76). Acute kidney injury was more common in patients who received CMS (48.5% vs 11.1%, p = 0.01). In our study, ceftolozane/tazobactam was more efficacious in the treatment of XDR Pseudomonas aeruginosa VAP and showed a better safety profile compared to CMS.
耐多药铜绿假单胞菌是重症监护病房（ICU）中的常见病原体，限制了可用的治疗选择。我们旨在比较头孢他啶/他唑巴坦（C/T）与多粘菌素 E 甲磺酸钠（CMS）在治疗广泛耐药（XDR）铜绿假单胞菌呼吸机相关性肺炎（VAP）中的疗效。这是一项在三级护理 ICU 进行的回顾性观察性研究。比较了接受 C/T 与全身 CMS 治疗的患者的临床和微生物学成功率、28 天全因死亡率和不良事件。共纳入 51 例患者（C/T 组 18 例，CMS 组 33 例）。C/T 组和 CMS 组的临床成功率分别为 13 例（72.2%）和 10 例（30.3%）。多变量回归分析显示，C/T 治疗与临床成功独立相关（比值比 4.47，95%CI 1.17-17.08）。28 天全因死亡率无差异（C/T 组和 CMS 组分别为 27.8%和 33.3%，p=0.76）。CMS 组急性肾损伤更为常见（48.5%与 11.1%，p=0.01）。在我们的研究中，头孢他啶/他唑巴坦在治疗 XDR 铜绿假单胞菌 VAP 方面更有效，与 CMS 相比具有更好的安全性。
