替加环素与粘菌素治疗癌症患者耐碳青霉烯肠杆菌科（CRE）感染的疗效和安全性比较

IF 2.3 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Clinical Epidemiology and Global Health Pub Date : 2025-03-21 DOI:10.1016/j.cegh.2025.101996

Sai Vaibhavi Gumudavelli , Akshay Shelke , Pallavi Priya , Richa Chauhan , Sameer Dhingra

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引用次数: 0

摘要

碳青霉烯耐药肠杆菌科（CRE）感染由于其高死亡率和有限的治疗选择而构成重大威胁，抗生素滥用和耐药基因的传播加剧了这一威胁。目的比较替加环素和粘菌素治疗癌症患者CRE感染的有效性、安全性和结局。方法在印度比哈尔邦的一家三级肿瘤医院进行了一项为期9个月的前瞻性观察研究。本研究纳入150例CRE感染患者，分为替加环素组（n = 90）和粘菌素组（n = 60）。结果接受替加环素治疗的患者直接胆红素、碱性磷酸酶和肌酐水平升高。然而，替加环素与较短的住院时间（13.73天对17.45天，p = 0.016）和治疗持续时间（5.7天对7.3天，p = 0.04）相关。两组患者的感染复发率（3.3% vs. 5%）和30天死亡率（17.6% vs. 18.9%, p = 0.663）相似。结论替加环素和粘菌素治疗肿瘤患者CRE感染均有较好的疗效。虽然替加环素与改善住院时间和治疗时间有关，但它也显示出潜在的肝肾功能不良反应。这些发现强调需要仔细考虑癌症患者CRE感染的治疗方案。

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Comparative efficacy and safety of tigecycline vs colistin for Carbapenem-resistant Enterobacteriaceae (CRE) infections in cancer patients

Background

Carbapenem-resistant Enterobacteriaceae (CRE) infections pose a significant threat owing to their high mortality rates and limited treatment options, exacerbated by antibiotic misuse and the spread of resistance genes.

Objective

This study aimed to compare the effectiveness, safety, and outcomes of tigecycline and colistin in the treatment of CRE infections in cancer patients.

Methods

A 9-month prospective observational study was conducted at a tertiary-care cancer hospital in Bihar, India. The study included 150 patients with CRE infections divided into tigecycline (n = 90) and colistin (n = 60) groups.

Results

Patients receiving tigecycline had higher levels of direct bilirubin, alkaline phosphatase, and creatinine. However, tigecycline was associated with shorter hospital stays (13.73 vs 17.45 days, p = 0.016) and therapy durations (5.7 vs 7.3 days, p = 0.04). Infection recurrence rates (3.3 % vs. 5 %) and 30-day mortality rates (17.6 % vs. 18.9 %, p = 0.663) were similar between the two groups.

Conclusion

Both tigecycline and colistin were effective in treating CRE infections in patients with cancer. Although tigecycline was associated with improved hospital stay and therapy duration, it also showed potential liver and kidney function adverse effects. These findings highlight the need for careful consideration of treatment options for CRE infections in patients with cancer.

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来源期刊

Clinical Epidemiology and Global Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-

CiteScore

4.60

自引率

7.70%

发文量

218

审稿时长

66 days

期刊介绍： Clinical Epidemiology and Global Health (CEGH) is a multidisciplinary journal and it is published four times (March, June, September, December) a year. The mandate of CEGH is to promote articles on clinical epidemiology with focus on developing countries in the context of global health. We also accept articles from other countries. It publishes original research work across all disciplines of medicine and allied sciences, related to clinical epidemiology and global health. The journal publishes Original articles, Review articles, Evidence Summaries, Letters to the Editor. All articles published in CEGH are peer-reviewed and published online for immediate access and citation.