两性霉素 B 诱导联合伏立康唑巩固治疗光滑念珠菌致 -相关棘白菌素耐药性败血性关节炎和骨髓炎。
Amphotericin B Induction with Voriconazole Consolidation as Salvage Therapy for -Associated Echinocandin Resistance in Candida glabrata Septic Arthritis and Osteomyelitis.
机构信息
Division of Infectious Diseases, Department of Medicine, University of Pittsburgh Medical Center, Harrisburg, Pennsylvania, USA
Department of Pharmacy and Therapeutics, University of Pittsburgh Medical Center, Harrisburg, Pennsylvania, USA.
出版信息
Antimicrob Agents Chemother. 2019 Jul 25;63(8). doi: 10.1128/AAC.00512-19. Print 2019 Aug.
Abstract
We report the case of a 61-year-old female with Crohn's disease dependent on total parenteral nutrition who developed a central venous catheter bloodstream infection and septic arthritis, complicated further by osteomyelitis and persistent fungemia. Fluconazole treatment led to persistent infection, and micafungin therapy failed with development of -associated resistance. Infection responded after initiation of amphotericin B plus voriconazole. Echinocandin resistance is increasingly recognized, suggesting a role for alternative antifungal therapies.
摘要
我们报告了一例依赖全胃肠外营养的 61 岁女性克罗恩病患者，她发生了中心静脉导管血流感染和脓毒性关节炎，进一步并发骨髓炎和持续性真菌血症。氟康唑治疗导致持续感染，米卡芬净治疗失败并出现相关耐药。两性霉素 B 联合伏立康唑治疗开始后感染得到缓解。棘白菌素类耐药性日益受到关注，提示需要选择替代抗真菌治疗。
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