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在一名肝移植受者中,使用基于磷霉素的多药方案成功治疗广泛耐药肺炎克雷伯菌的播散性感染。

Successful treatment of a disseminated infection with extensively drug-resistant Klebsiella pneumoniae in a liver transplant recipient with a fosfomycin-based multidrug regimen.

作者信息

Mills J P, Wilck M B, Weikert B C, Porrett P M, Timko D, Alby K, Bonomo R A, Blumberg E A

机构信息

Division of Infectious Diseases, Department of Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA.

Division of Infectious Diseases, Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA.

出版信息

Transpl Infect Dis. 2016 Oct;18(5):777-781. doi: 10.1111/tid.12578. Epub 2016 Sep 7.

DOI:10.1111/tid.12578
PMID:27458980
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5050106/
Abstract

Donor-derived infections with multidrug-resistant gram-negative bacteria are associated with poor outcomes, in part because of limited treatment options. Here, we describe a case of donor-derived, disseminated infection with colistin-resistant, carbapenemase-producing Klebsiella pneumoniae in a liver transplant recipient that was cured with addition of intravenous fosfomycin to a multidrug regimen, in conjunction with aggressive surgical source control. Intravenous fosfomycin represents a promising adjunctive agent for use in treatment of extensively drug-resistant infections in immunocompromised hosts.

摘要

供体来源的耐多药革兰氏阴性菌感染与不良预后相关,部分原因是治疗选择有限。在此,我们描述了一例肝移植受者发生供体来源的、播散性耐黏菌素、产碳青霉烯酶肺炎克雷伯菌感染的病例,该病例通过在多药治疗方案中加用静脉注射磷霉素并结合积极的手术源头控制得以治愈。静脉注射磷霉素是一种有前景的辅助药物,可用于治疗免疫功能低下宿主的广泛耐药感染。

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本文引用的文献

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Incidence of carbapenem-resistant gram negatives in Italian transplant recipients: a nationwide surveillance study.意大利移植受者中耐碳青霉烯革兰氏阴性菌的发病率:一项全国性监测研究。
PLoS One. 2015 Apr 2;10(4):e0123706. doi: 10.1371/journal.pone.0123706. eCollection 2015.
2
Fosfomycin susceptibility in carbapenem-resistant Enterobacteriaceae from Germany.德国耐碳青霉烯类肠杆菌科细菌对磷霉素的敏感性
J Clin Microbiol. 2014 Jun;52(6):1893-7. doi: 10.1128/JCM.03484-13. Epub 2014 Mar 19.
3
Outcomes of critically ill intensive care unit patients treated with fosfomycin for infections due to pandrug-resistant and extensively drug-resistant carbapenemase-producing Gram-negative bacteria.
死亡器官捐献者中多重耐药菌的危险因素。
Am J Transplant. 2019 Sep;19(9):2468-2478. doi: 10.1111/ajt.15488. Epub 2019 Jun 26.
4
Polymyxins: To Combine or Not to Combine?多粘菌素:联合还是不联合?
Antibiotics (Basel). 2019 Apr 10;8(2):38. doi: 10.3390/antibiotics8020038.
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Case Report of an Extensively Drug-Resistant Infection With Genomic Characterization of the Strain and Review of Similar Cases in the United States.广泛耐药感染病例报告及菌株基因组特征分析与美国类似病例综述
Open Forum Infect Dis. 2018 Apr 6;5(5):ofy074. doi: 10.1093/ofid/ofy074. eCollection 2018 May.
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Transpl Infect Dis. 2018 Feb;20(1). doi: 10.1111/tid.12795. Epub 2017 Nov 27.
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Donor-derived infections among Chinese donation after cardiac death liver recipients.在接受心脏死亡供肝移植的中国患者中,供者源性感染。
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Liver Transpl. 2012 Apr;18(4):468-74. doi: 10.1002/lt.23374.
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The revival of fosfomycin.磷霉素的复兴。
Int J Infect Dis. 2011 Nov;15(11):e732-9. doi: 10.1016/j.ijid.2011.07.007. Epub 2011 Sep 25.
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Clin Microbiol Infect. 2011 Nov;17(11):E9-E11. doi: 10.1111/j.1469-0691.2011.03649.x. Epub 2011 Sep 21.
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Risk factors and outcomes associated with acquisition of colistin-resistant KPC-producing Klebsiella pneumoniae: a matched case-control study.与获得多粘菌素耐药产 KPC 肺炎克雷伯菌相关的危险因素和结局:一项匹配病例对照研究。
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Clin Infect Dis. 2008 Apr 1;46(7):1121-2; author reply 1122. doi: 10.1086/528867.