依拉环素治疗肺移植受者耐碳青霉烯菌感染：一项真实世界回顾性研究。
Eravacycline Treatment for Carbapenem-Resistant in Lung Transplant Recipients: A Real-World Retrospective Study.
作者信息
Chen Juan, Qian Xingxian, Yue Bingqing, Lin Huiru, Ding Shuo, Chen Jingyu, Huang Man
机构信息
Department of General Intensive Care Unit, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, People's Republic of China.
Key Laboratory of Multiple Organ Failure, Zhejiang University, Ministry of Education, Hangzhou, Zhejiang, People's Republic of China.
出版信息
Infect Drug Resist. 2025 Aug 16;18:4125-4139. doi: 10.2147/IDR.S529016. eCollection 2025.
BACKGROUND
Carbapenem-resistant (CRAB) infections were associated with higher mortality and significant healthcare burden. Novel antibiotics provided a powerful weapon against CRAB. This study aimed to describe the effectiveness of eravacycline for the treatment of CRAB infections in lung transplant recipients.
METHODS
This was a single-center, retrospective study that enrolled lung transplant recipients with CRAB infections who received eravacycline for over 72 hours between August 2023 and December 2024. The primary outcome was 28-day survival rate. Secondary outcomes included 14-day survival and clinical failure rate.
RESULTS
A total of 24 lung transplant recipients were enrolled, with a median age of 60.5 years and a predominance of male patients. Nearly half had interstitial lung disease as the primary pulmonary condition. These recipients in our study mainly had pulmonary infections attacked by CRAB, with six individuals suffering septic shock. The median duration of eravacycline therapy was 10 days, with most patients receiving combination therapy. The primary outcome, the 28-day survival rate, was 83.3%, while the secondary outcomes showed a 14-day survival rate of 100% and a clinical failure rate of 37.5%. The median ICU and hospital lengths of stay were 12.5 and 55 days, respectively. A comparison between patients with and without clinical failure showed that those with clinical failure were older, had a higher incidence of septic shock, a higher proportion of continuous renal replacement therapy, and a longer ICU stays. Additionally, these patients exhibited an elevated heart rate, higher levels of ALT and AST, lower protein levels (total protein, albumin), prolonged PT and APTT, and increased level of CRP and PCT at the end of treatment.
CONCLUSION
This study presented the clinical efficacy of eravacycline in lung transplant recipients with CRAB infections, providing valuable evidence and clinical experience for its use in organ transplant populations.
背景
耐碳青霉烯类鲍曼不动杆菌（CRAB）感染与更高的死亡率及巨大的医疗负担相关。新型抗生素为对抗CRAB提供了有力武器。本研究旨在描述依拉环素治疗肺移植受者CRAB感染的有效性。
方法
这是一项单中心回顾性研究，纳入了2023年8月至2024年12月期间接受依拉环素治疗超过72小时的CRAB感染肺移植受者。主要结局为28天生存率。次要结局包括14天生存率和临床失败率。
结果
共纳入24例肺移植受者，中位年龄为60.5岁，男性患者居多。近一半患者以间质性肺疾病作为主要肺部疾病。本研究中的这些受者主要发生了CRAB所致的肺部感染，6例发生感染性休克。依拉环素治疗的中位持续时间为10天，大多数患者接受联合治疗。主要结局28天生存率为83.3%，而次要结局显示14天生存率为100%，临床失败率为37.5%。ICU和住院的中位时长分别为12.5天和55天。有临床失败与无临床失败的患者对比显示，有临床失败的患者年龄更大，感染性休克发生率更高，接受持续肾脏替代治疗的比例更高，ICU住院时间更长。此外，这些患者在治疗结束时心率升高，ALT和AST水平更高，蛋白水平（总蛋白、白蛋白）更低，PT和APTT延长，CRP和PCT水平升高。
结论
本研究展示了依拉环素治疗CRAB感染肺移植受者的临床疗效，为其在器官移植人群中的应用提供了有价值的证据和临床经验。
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