创伤后脑内鲍曼不动杆菌感染采用替加环素和多黏菌素 B 序贯脑室注射治疗: 一例病例报告并文献复习。
Sequential intraventricular injection of tigecycline and polymyxin B in the treatment of intracranial Acinetobacter baumannii infection after trauma: a case report and review of the literature.
机构信息
Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, 510515, China.
Department of Critical Care Medicine, the First Affiliated Hospital of Guizhou University of Chinese Medicine, Guiyang, 550001, China.
出版信息
Mil Med Res. 2020 May 10;7(1):23. doi: 10.1186/s40779-020-00253-9.
BACKGROUND
Intracranial infection after craniotomy is one of the most serious postoperative complications, especially multidrug-resistant (MDR) or extensively drug-resistant (XDR) bacterial meningitis, and strongly affects the prognosis of patients. Current treatment experience regarding these infections is scarce.
CASE PRESENTATION
We report a case of severe intracranial infection of XDR Acinetobacter baumannii (A. baumannii) that was treated by intravenous (IV) injection, sequential intraventricular (IVT) injection of tigecycline and polymyxin B, and other anti-infective drugs. Good results were obtained, and the patient was eventually discharged from the hospital. This case is characterized by intracranial infection.
CONCLUSIONS
The polymyxin B IV + IVT pathway is an ideal treatment strategy for XDR A. baumannii. The tigecycline IVT pathway is also a safe treatment option.
背景
开颅术后颅内感染是最严重的术后并发症之一，尤其是耐多药（MDR）或广泛耐药（XDR）细菌性脑膜炎，强烈影响患者的预后。目前针对这些感染的治疗经验很少。
病例介绍
我们报告了一例严重的 XDR 鲍曼不动杆菌（A.baumannii）颅内感染患者，采用静脉（IV）注射、替加环素序贯脑室内（IVT）注射和多黏菌素 B 及其他抗感染药物治疗，取得了良好的效果，患者最终出院。该病例的特点是颅内感染。
结论
多黏菌素 B IV+IVT 途径是 XDR A.baumannii 的理想治疗策略。替加环素 IVT 途径也是一种安全的治疗选择。
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