Linezolid Treatment for Methicillin-Resistant Staphylococcus aureus Infection in Critically Ill Patients

以Linezoid治療重症病患的抗Methicillin金黃色葡萄球菌感染

王誠一(Cheng-Yi Wang) ； 吳允升(Vin-Cent Wu) ； 鄭之勛(Jih-Shuin Jerng) ； 余忠仁(Chong-Jen Yu) ； 薛博仁(Po-Ren Hsueh) ； 楊泮池(Pan-Chyr Yang)

《胸腔醫學》 20卷6期 (2005/12) Pp. 574-581

https://doi.org/10.29806/TM.200512.0009

摘要

背景：Linezolid主要用在vancomycin或teicoplanin治療失敗的MRSA感染，本研究乃針對重症病患使用linezolid治療MRSA感染之療效。
方法：我們回溯性分析2002年11月到2004年12月中，加護病房病人因為MRSA感染需要使用Linezolid進行治療的相關紀錄，包括臨床和微生物學方面的資料。
結果：全部總共25位病人，平約年齡是64.8歲，88%是男性。最常見的既有疾病是末期腎衰竭(48%)和高血壓(48%)，主要的感染是肺炎(64%)；使用Linezolid治療在微生物上可以獲得60%成功，14%難以判定，24%失敗；臨床上36%可以治癒，12%難以判定，52%失敗。血小板低下(72%)和貧血(44%)是最常見的副作用。單變數分析發現，臨床上治療成功與否和糖尿病以及治療期間有無腎衰竭有關。
結論：Linezolid在vancomycin或teicoplanin治療失敗的MRSA感染之重症病志，仍有相當不錯的效果，但要小心發生血小板低下或貧血。

並列摘要

Background: Linezolid is indicated in MRSA (methicillin-resistant Staphylococcus aureus) infections that do not respond well to vancomycin or teicoplanin; however, data concerning its efficacy in critically ill patients remain limited. The aim of this study was to evaluate the efficacy of treatment for MRSA infection with linezolid in critically ill patients.
Patients and Methods: We retrospectively reviewed the medical records and microbiological data of patients who had received linezolid for MRSA infection during ICU admission from November 2002 to December 2004. The microbiological as well as clinical responses to treatment were evaluated.
Results: A total of 25 patients (median age, 64.8 years; 88% male) were included. End- stage renal disease (48%) and hypertension (48%) were the most common co-morbidities. Pneumonia was the most common infection site (64%). Treatments with linezolid were 60% successful microbiologically, with 14% intermediate responses and 24% failures. Clinically, 36% of infections were cured, 12% were considered as intermediate, and 52% failures. Thrombocytopenia (72%) and anemia (44%) were the most common adverse reactions. Univariate analysis showed that diabetes and renal failure during admission were associated with a decreased probability of clinical cure.
Conclusions: The efficacy of linezolid in MRSA infection in critically ill patients remains high, despite a previous failure with vancomycin or teicoplanin. However, the potential development of anemia and thrombocytopenia during drug use should also be kept in mind.

並列關鍵字

Linezolid ； Vancomycin ； MRSA