Huang C R, Lu C H, Chuang Y C, Tsai N W, Chang C C, Chen S F, Wang H C, Chien C C, Chang W N
Department of Neurology, Chang Gung Memorial Hospital-Kaohsiung, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Jpn J Infect Dis. 2007 Nov;60(6):397-9.
We analyzed the clinical and laboratory characteristics, therapeutic outcome and prognostic factors of 25 cases of cerebrospinal fluid (CSF) culture-proven Pseudomonas aeruginosa adult bacterial meningitis (ABM). Twelve P. aeruginosa strains, isolated from clinical CSF specimens, were tested for antibiotic susceptibility. The 25 cases included 17 men and 8 women, aged 17 to 86 years (median=51). Of the 25 cases of P. aeruginosa ABM, 18 were the result of postneurosurgical infection and the other 7 were spontaneous infections. The latter 7 cases had serious underlying medical conditions. The antibiotic susceptibility rates of the 12 strains were as follows: ceftriaxone 16.7% (2/12), ceftazidime 91.7% (11/12), cefepime 83.3% (10/12), imipenem 83.3% (10/12), meropenem 83.3% (10/12) and ciprofloxacin 66.7% (8/12). The therapeutic results showed an overall mortality rate of 40% (10/25). The emergence of third-generation cephalosporin-resistant P. aeruginosa strains cultured from clinical CSF specimens in recent years has resulted in a therapeutic challenge in the treatment of ABM.
我们分析了25例脑脊液（CSF）培养证实的铜绿假单胞菌所致成人细菌性脑膜炎（ABM）的临床和实验室特征、治疗结果及预后因素。对从临床脑脊液标本中分离出的12株铜绿假单胞菌进行了药敏试验。25例患者中，男性17例，女性8例，年龄17至86岁（中位数 = 51岁）。在25例铜绿假单胞菌所致ABM中，18例为神经外科手术后感染，另外7例为自发性感染。后7例患者有严重的基础疾病。12株菌株的药敏率如下：头孢曲松16.7%（2/12），头孢他啶91.7%（11/12），头孢吡肟83.3%（10/12），亚胺培南83.3%（10/12），美罗培南83.3%（10/12），环丙沙星66.7%（8/12）。治疗结果显示总死亡率为40%（10/25）。近年来，从临床脑脊液标本中培养出的对第三代头孢菌素耐药的铜绿假单胞菌菌株给ABM的治疗带来了挑战。
