多黏菌素B治疗粒细胞缺乏伴难治性革兰阴性菌血流感染27例临床观察

OBJECTIVE: To assess the efficacy and safety of polymyxin B in neutropenic patients with hematologic disorders who had refractory gram-negative bacterial bloodstream infection. METHODS: From August 2021 to July 2022, we retrospectively analyzed neutropenic patients with refractory gram-negative bacterial bloodstream infection who were treated with polymyxin B in the Department of Hematology of the First Affiliated Hospital of the Soochow University between August 2021 to July 2022. The cumulative response rate was then computed. RESULTS: The study included 27 neutropenic patients with refractory gram-negative bacterial bloodstream infections. Polymyxin B therapy was effective in 22 of 27 patients. The median time between the onset of fever and the delivery of polymyxin B was 3 days [interquartile range (IQR): 2–5]. The median duration of polymyxin B treatment was 7 days (IQR: 5–11). Polymyxin B therapy had a median antipyretic time of 37 h (IQR: 32–70). The incidence of acute renal dysfunction was 14.8％（four out of 27 cases）, all classified as “injury” according to RIFLE criteria. The incidence of hyperpigmentation was 59.3％. CONCLUSION: Polymyxin B is a viable treatment option for granulocytopenia patients with refractory gram-negative bacterial bloodstream infections.