Study On Curative Effect Of Vancomycin In Infected Infant Patients With Hypoalbuminemia

Objective Hypoalbuminemia is one of common clinical disease complications,which can affect the treatments and prognoses of many diseases.When hypoalbuminemia happens,some drugs may be characterized by a high concentration of free drugs,thus changing the drug pharmacokinetics and efficacy.Vancomycin(VCM)plays an important role in treating infectious diseases.However,there is no laboratory evidence for the dosage of VCM in the case of hypoalbuminemia.This study will determine serum bactericidal activity of vancomycin in vitro and analyzing the blood drug concentration and clinical efficacy of VCM of normal and infected infant patients with hypoalbuminemia,aiming to know curative effect of vancomycin in infected patients with hypoalbuminemia.Methods 1 Cell culture The single colony of MRSA was activated and isolated by dilution-plate methodand was subcultivated.The single colony of MRSA was then incoculated in TSB liquid culture media and TSA solid medium.2 Protocol 2.1 Determing serum bactericidal activity of VCM in vitro:setting up control group,VCM groups(16?8?4?3.7?3.5?2.5?2 ?g·m L-1)2.2 Simulating hypoalbuminemia in vitro and determing antimicrobial activity of VCM:setting up normal control group,VCM groups(16?8?4?3.7?2 ?g·m L-1)according to different degree of hypoalbuminemia(40?20?10 g·L-1)3 Measurements and methodology 3.1 Using Lowry protein assay kit to determine the concentration of plasm protein.3.2 Using bacteria turbidity instrument to determine the concentration of bacteria.3.3 Using photoelectric turbidimetric method to determine the light absorption value of MRSA and draw the corresponding growth curve as well as measuring the inhibition rate of MRSA.4 Cases collection and protocol Collecting related information about infant patients in our hospital who received the VCM therapy and recording.in the meantime,the patients were devided into two groups according to the concentration of plasma protein,the one was normal protein group(plasma total protein concentration ? 60g·L-1)and the low protein group(plasma total protein concentration<60g·L-1).Analysing and compare stable valley concentration of VCM and clinical effect.Result 1 Standard regression curve equation of plasma protein concentration is : Y=1.176X+2.5×10-2(R2=0.9941.The concentration plasma protein content is 80.24 mg·m L-1.2 VCM(16?8?4?3.8? 3.7?3.5?2.5?2?g·m L-1)can inhibit the growth of MRSA.VCM dose – dependently inhibits MRSA.3 The inhibitory rate of VCM(16?8?4?3.7?2?g·m L-1)in MRSA culturing in 40g·L-1 plasma protein content medium is significant lower than 10?20g·L-1 plasma protein content medium(P<0.05).4 The valley concentration of VCM and clinical efficacy in infected infant patients with hypoalbuminemia(6.11 ± 2.23 ?g·m L-1 vs.7.92 ± 2.47 ?g·m L-1;75.0% vs.92.1%)(P<0.05).Conclusion 1 Inhibitory effect of VCM deceases with the increase of plasma protein content;2 The trough concentration and efficacy effect of infected infant patients with low protein...