Renal Services, North Shore Hospital, Waitematā District Health Board, Auckland, New Zealand.
Infectious Diseases, North Shore Hospital, Waitematā District Health Board, Auckland, New Zealand.
Perit Dial Int. 2020 Jan;40(1):100-102. doi: 10.1177/0896860819879879.
Multidrug-resistant organisms cause significant morbidity and mortality. Infections due to resistant gram-negative bacilli are increasingly being reported. For years, carbapenem antibiotics have been successfully used to treat infections due to resistant Enterobacteriaceae, such as and , including those producing extended spectrum β-lactamases, a subset of β-lactamase enzymes that confer broad resistance to penicillins and cephalosporins. More recently, carbapenem-resistant Enterobacteriaceae have emerged as pathogenic organisms, which confer broad resistance to most β-lactam antibiotics including 'last-line' carbapenems. However, different types of carbapenemases confer diverse spectra of antibiotic resistance. Here, we describe the case of an 84-year-old lady on peritoneal dialysis (PD) for 3 years who, on developing carbapenem-resistant PD peritonitis, was successfully treated with colistin, an antimicrobial agent first used in the 1950s.
耐多药生物体可导致严重的发病率和死亡率。越来越多的报道称，耐药革兰氏阴性杆菌引起的感染。多年来，碳青霉烯类抗生素已成功用于治疗耐药肠杆菌科细菌引起的感染，包括产生超广谱β-内酰胺酶的细菌，这些酶可广泛抵抗青霉素和头孢菌素类抗生素。最近，碳青霉烯类耐药肠杆菌科细菌已成为致病生物体，对包括“最后一线”碳青霉烯类在内的大多数β-内酰胺类抗生素具有广泛的耐药性。然而，不同类型的碳青霉烯酶可导致不同类型的抗生素耐药性。在这里，我们描述了一位 84 岁的女性腹膜透析（PD）患者的病例，她患有 3 年的腹膜透析相关腹膜炎，对碳青霉烯类耐药。她成功地使用了多粘菌素，这是一种在 20 世纪 50 年代首次使用的抗菌药物。
