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目的评价血液科利奈唑胺注射液治疗患者院内感染的临床疗效及安全性。方法对2009年4月至2010年5月上海瑞金医院血液科使用利奈唑胺治疗的33例发生院内感染的住院患者进行回顾性分析和总结。结果用药前16例患者检出革兰阳性菌株14株(77.8%),其中葡萄球菌属4株(12.1%),VRE3株(9.1%),屎肠球菌2株(6.1%),粪肠球菌3株(9.1%),鸟肠球菌2株(6.1%)。33例患者中,初始使用利奈唑胺4例(12.1%),换用利奈唑胺治疗29例(87.9%)。细菌清除率达86.7%。33例患者均在治疗后3～5d感染症状缓解,临床有效率75.8%。6例(18.2%)在使用利奈唑胺期间出现了不良反应,1例轻度呕吐,1例恶心,1例面部水肿,1例视物模糊,2例患者轻度腹泻。结论利奈唑胺可有效治疗血液科患者院内感染,部分病例为使用其他抗菌药物治疗效果不佳或无效时换用利奈唑胺,在本研究中未观察到利奈唑胺对于血液疾病患者化疗后的骨髓有明显的抑制作用。患者耐受性良好,疗效确切。
Objective To evaluate the clinical efficacy and safety of blood linezolid in the treatment of nosocomial infections in patients. Methods A retrospective analysis and summary of 33 hospitalized patients with nosocomial infection treated with linezolid in Department of Hematology, Shanghai Ruijin Hospital from April 2009 to May 2010 were retrospectively analyzed. Results In the 16 patients before the treatment, 14 strains (77.8%) of gram-positive strains were detected, of which Staphylococcus was 4 (12.1%), VRE3 (9.1%), Enterococcus faecium 2 3 strains (9.1%) and 2 Enterococcus (6.1%). Of the 33 patients, 4 (12.1%) patients initially received linezolid and 29 (87.9%) patients received linezolid. Bacterial clearance rate of 86.7%. Thirty-three patients were relieved of symptoms 3 to 5 days after treatment, with a clinical effective rate of 75.8%. Six patients (18.2%) experienced adverse reactions during the use of linezolid, one with mild vomiting, one with nausea, one with facial edema, one with blurred vision, and two with mild diarrhea. Conclusion Linezolid is effective in the treatment of nosocomial infections in patients with hematologic diseases. In some cases, linezolid is used for the treatment of poor or ineffective use of other antimicrobial agents. In this study, linezolid was not observed in patients with blood diseases after chemotherapy Bone marrow has a significant inhibitory effect. Patient well tolerated, curative effect.