Klebsiella Pneumoniae Pneumonia
Conditions
Keywords
Fecal Microbiota Transplantation, Multiple Drug Resistant Klebsiella Pneumoniae Pneumonia
Brief summary
Multidrug-resistant Klebsiella pneumoniae (MDR-KP) infections account for 10% of all nosocomial infections, and even with effective antibiotics, the mortality rate is as high as 50%. Intestinal bacteria transplantation can not only treat intestinal diseases, but also inhibit the colonization and proliferation of drug-resistant bacteria. This study explored the therapeutic value of fecal microbiota transplantation in patients with MDR-KP pneumonia.
Detailed description
Intervention study (controlled clinical study) : patients with multidrug-resistant Klebsiella pneumoniae pneumonia were randomly assigned to the experimental group (conventional antibiotic treatment + fecal microbiota transplantation) and the control group (conventional antibiotic treatment); The clinical symptoms, inflammatory indexes, immune indexes, intestinal microecology, respiratory microecology and antibiotic resistance gene changes were compared between the two groups.
Interventions
OTHERFecal Microbiota Transplantation
Patients in the experimental group received conventional antibiotic therapy plus fecal microbiota transplantation, and the efficacy was compared with that in the control group
Sponsors
luxia Kong
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 75 Years
Healthy volunteers
Yes
Inclusion criteria
* Age 18-75; * Meet the diagnostic criteria for community-acquired pneumonia or hospital-acquired pneumonia; * The etiological results of sputum or alveolar lavage fluid suggested MDR-KP infection; * The patient or his family members voluntarily participated, collected alveolar lavage fluid and stool samples, agreed to perform FMT treatment, and signed the informed consent.
Exclusion criteria
* Subjects with persistent bronchial asthma, severe pulmonary dysfunction, or inability to tolerate bronchoscopy; * Patients with severe damage of intestinal barrier such as sepsis and digestive tract perforation due to various reasons; * Those currently diagnosed with explosive colitis or toxic megacolon have gastroesophageal reflux disease or peptic ulcer; Subjects taking probiotics within 6 months; * Enteral nutrition patients who could not tolerate 50% of heat calorie requirements due to severe diarrhea, significant fibrous intestinal stenosis, severe gastrointestinal bleeding, high-flow intestinal fistula and other reasons. * Patients with obvious bleeding tendency, severe pulmonary hypertension, superior vena cava obstruction, and aortic aneurysm rupture risk; * Patients with malignant hypertension, recent myocardial infarction (≤6 months), severe arrhythmia, and cardiac insufficiency; * suffering from malignant tumor diseases, congenital or acquired immune deficiency diseases, other systemic inflammatory response diseases; * Those who have recently been treated with high-risk immunosuppressive/cytotoxic drugs, such as rituximab, doxorubicin, or steroid hormones (20mg/d ponisone or higher) for more than 4 weeks; * Severe immunosuppression: adult neutrophils \<1 500/mm3, child neutrophils \<1 000/mm3; * Pregnancy or lactation; * There is a mental disability or active mental illness that prevents informed consent; * Conditions deemed unsuitable for study inclusion by other clinicians.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Number of days MDR-KP turns negative | one month | The number of days that multidrug-resistant Klebsiella pneumoniae turned negative after treatment |
| Length of hospital stay | one month | Total length of stay from admission to discharge or death |
| mortality rate | one month | The ratio of death cases to the total number of patients |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| The Incidence of fever | one month | The incidence of fever in patients was included |
| The incidence of chest pain assessed by VAS | one month | The incidence of chest pain in patients was included |
| The incidence of cough | one month | The incidence of cough in patients was included |
| The incidence of phlegm | one month | The incidence of phlegm in patients was included |
Countries
China
Contacts
Primary ContactLuxia Kong, master
Backup ContactShuang Geng, doctor
Outcome results
None listed