Department of Surgical ICU, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center For Child Health, Hangzhou, 310052, China.
Department of Neurosurgery, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center For Child Health, Hangzhou, 310052, China.
World J Pediatr. 2020 Oct;16(5):528-532. doi: 10.1007/s12519-020-00350-8. Epub 2020 Mar 19.
Increased meningitis caused by extensively drug-resistant bacillary presents a significant challenge in antibiotic selection. The aim of our study was to evaluate the efficacy and safety of polymyxin in the treatment of post-neurosurgical meningitis due to the extensively drug-resistant bacillary in children.
We performed a retrospective study on post-neurosurgical meningitis caused by the extensively drug-resistant bacillary in children, who were treated with polymyxin for ≥ 3 days.
Among five post-neurosurgical meningitis cases that were included, the children were infected by Acinetobacter baumannii (n = 3), Klebsiella pneumonia (n = 1), and Pseudomonas aeruginosa (n = 1). The drug susceptibility test showed that they were extensively drug-resistant bacillary. Two patients received intravenous polymyxin E. Three children received intravenous combined with intraventricular injection of polymyxin B. One patient infected by Klebsiella pneumonia eventually died of septic shock. No serious adverse effects of polymyxin were observed.
Polymyxin is a safe and effective therapy for post-neurosurgical, multidrug-resistant bacillary meningitis in children.
广泛耐药的细菌性脑膜炎的发病率增加，这给抗生素的选择带来了重大挑战。我们的研究目的是评估黏菌素在儿童因广泛耐药菌引起的神经外科术后脑膜炎治疗中的疗效和安全性。
我们对接受黏菌素治疗≥3 天的儿童广泛耐药菌引起的神经外科术后脑膜炎进行了回顾性研究。
纳入的 5 例神经外科术后脑膜炎患儿中，感染的细菌分别为鲍曼不动杆菌（n=3）、肺炎克雷伯菌（n=1）和铜绿假单胞菌（n=1）。药敏试验显示均为广泛耐药菌。2 例患儿接受静脉注射黏菌素 E，3 例患儿接受静脉联合脑室内注射黏菌素 B。1 例感染肺炎克雷伯菌的患儿最终死于感染性休克。未观察到黏菌素的严重不良反应。
黏菌素是治疗儿童神经外科术后多重耐药菌性细菌性脑膜炎的一种安全有效的方法。
