ABSTRACT
Objective To analyze the pathogenic characteristics and resistance of severe lung infection patients in Suining area, and to provide a reference for early clinical intervention. Methods A total of 359 patients with pulmonary infection were selected in Suining city from December 2019 to December 2020.The patients were divided into mild group (231 cases) and severe group (128 cases) according to the severity of nosocomial pneumonia.Sputum samples were collected for pathogen identification and drug sensitivity test. Multivariate logistic regression was used to analyze the influencing factors of severe pulmonary infection. Results There were 128 cases of severe pneumonia in 359 patients with traumatic brain injury. 147 strains of pathogenic bacteria were isolated, including 91 strains (61.90%) of gram-negative bacteria, mainly including 42 strains (28.57%) of Acinetobacter baumannii, 29 strains (19.73%) of Pseudomonas aeruginosa and 16 strains (10.88%) of Klebsiella pneumoniae. There were 37 gram-positive strains (25.17%), and 31 strains (21.09%) were staphylococcus aureus. A total of 19 strains of fungi (12.93%); Acinetobacter baumannii and Klebsiella pneumoniae were more sensitive to cefoperazone sodium sulbactam sodium and iaropenem, and more resistant to benzylbenzicillin, sulfamethoxazole/trimethoprazine and cefazolin. Pseudomonas aeruginosa had higher sensitivity to ceftazidine, piperacillin/tazobactam, and higher resistance to cefazolin sodium, ampicillin and other drugs. Staphylococcus aureus was highly sensitive to linezolid, vancomycin and teicoranin, and had high resistance to cefazolin and penicillin. There were statistically significant differences between the two groups in age, GCS score, combined basic diseases >2, coma time >24h, hypoproteinemia and invasive operation (P<0.05). Logistic regression analysis showed that GCS score, hypoproteinemia and invasive operation were independent risk factors for severe pulmonary infection in patients with traumatic brain injuries (P<0.05). Conclusion Suining patients with gram-negative bacteria, mainly Acinetobacter baumannii, Pseudomonas aeruginosa, aeruginosa, should be based on the pathogen susceptibility results of patients, for invasive operation, high GCS score should be positive treatment, and actively correct hypoproteinemia, can reduce the occurrence of severe lung infection.
ABSTRACT
Objective To study the clinical effects and mechanism of Xuebijing injection combined with antibiotics in the treatment of severe lung infection in ICU.Methods 110 cases of ICU severe lung infection were randomly divided into control group(55 cases) and observation group(55 cases).The control group was administered with cefotaxime sodium and sodium benzene azole penicillin,while the observation group was co-administered with Xuebijing injection and cefotaxime sodium,sodium benzene azole penicillin.All treatment lasted for 7 days.Meanwhile,the serum levels of C-reactive protein (CRP),TNF-α,IL-6,COX-2 and SOD were measured before and after the therapy.Results After treatment,the levels of CRP and TNF-α,IL-6 were significantly reduced in the two groups[after treatment CRP,TNF-α,IL-6 levels of the control group:(46.50 ± 17.74) ng/L,(339.50 ± 112.61) ng/L,(141.20 ± 42.66) ng/L;and those in the observation group:(35.60 ± 16.89) ng/L,(268.20 ± 98.47) ng/L,(118.70 ± 39.81) ng/L;the control group:t =7.329,9.682,6.038;the observation group:t =11.012,14.335,14.335,all P ＜ 0.01],and the reduced amplitude of the observation group was significantly lower than that of the control group (t =3.300,P ＜ 0.01).The serum levels of COX-2 and SOD were significantly reduced [after treatment COX-2 and SOD levels of the control group:(189.50 ± 34.52) ng/L,(203.60 ± 67.26) U/mL;those of the observation group:(118.20 ± 25.36) ng/L,(162.30 ± 59.78) U/mL;COX-2:the control group:t =15.021,P ＜ 0.01;the observation group:t =32.931,P ＜ 0.01;SOD:the control group,t =4.183,P ＜ 0.01;the observation group,t =7.682,P ＜0.01],and the reduced amplitude of the observation group was significantly lower than that of the control group(t =3.404,P ＜0.01).Conclusion Xuebijing injection combined with antibiotics in the treatment of severe lung infection in ICU has good effects,which is due to the inhibition of COX-2 and SOD to improve inflammation and oxidative stress damage in cells.
ABSTRACT
OBJECTIVE:To compare the clinical efficacy and safety of imipenem and cislastatin sodium and meropenem in the treatment of acute leukemia granulocytopenic phase combined with severe lung infection. METHODS:A total of 64 patients with acute leukemia granulocytopenic phase combined with severe lung infection were selected from our hospital during Jul. 2015-Jul. 2016 as study objects. They were divided into trial group(odd number)and control group(even number)according to admis-sion order,with 32 cases in each group. Control group was given Meropenem for injection 1 g+0.9％ Sodium chloride injection 100 mL,ivgtt(about 30 min),q8 h. Trial group was given Imipenem and cislastatin sodium for injection 1 g+0.9％ Sodium chlo-ride injection 100 mL,ivgtt(about 30 min),q12 h. Both groups were treated for 14 d. Clinical efficacies as well as blood gas pa-rameters [p(O2),p(CO2),SaO2] and pathogenic clearance were observed in 2 groups,and the occurrence of ADR was recorded. RESULTS:The total response rate of trial group(78.13％)was significantly higher than that of control group(71.88％),with sta-tistical significance (P0.05). After treatment,the levels of p(O2) and SaO2 in 2 groups were in-creased significantly,while the level of p(CO2) was decreased significantly;there was statistical significance compared to be-fore treatment(P>0.05). There were 27 cases of pathogenic clearance in trial group(clearance rate of 84.38％),which was sig-nificantly more than control group (26 cases,clearance rate of 81.25％),without statistical significance (P>0.05). The inci-dence of ADR in trial group(9.38％)was significantly lower than control group(15.63％),without statistical significance(P>0.05). CONCLUSIONS:Imipenem and cislastatin sodium and meropenem show good clinical efficacy for acute leukemia granu-locytopenic phase combined with severe lung infection,blood gas parameters improvement and pathogenic clearance effect,both of them have good safety.