Department of Epidemiology and Clinical Research Methodology, Medical University, Lublin, Poland.
Chair and Department of Medical Microbiology, Medical University, Lublin, Poland.
Ann Agric Environ Med. 2021 Dec 29;28(4):724-728. doi: 10.26444/aaem/140111. Epub 2021 Jul 20.
An 85-year-old male with a tumour in his right lung was admitted to Internal Diseases Ward to continue treatment after suffering a sudden cardiac arrest. An empiric antibiotic therapy with amoxycillin was introduced due to increased inflammation markers. Blood and sputum were collected. An abundant growth of AmpC β-lactamase-producing Citrobacter freundii was observed in culture grown from the sputum. The antibiogram showed retained sensitivity to fluoroquinolones. The therapy was modified by replacing β-lactam with ciprofloxacin. Neither clinical nor laboratory improvement were observed. Blood culture indicated sepsis of Acinetobacter baumannii etiology. The strain was suspected of producing OXA carbapenemase (CARBA test positive), KPC (-), MBL (-). Antibiogram illustrated retained sensitivity to gentamicin and colistin with complete resistance to ciprofloxacin. Another modification in treatment was implemented and ciprofloxacin was replaced with colistin.
一位 85 岁男性，因右肺肿瘤入住内科病房，在经历了一次心搏骤停后继续接受治疗。由于炎症标志物升高，采用了氨苄西林经验性抗生素治疗。采集了血液和痰液样本。从痰液中培养出的细菌大量生长产 AmpC 酶的弗劳地柠檬酸杆菌。药敏试验显示对氟喹诺酮类药物仍保持敏感。治疗方案通过用环丙沙星替代β-内酰胺类药物进行了修改。未观察到临床或实验室改善。血培养提示鲍曼不动杆菌引起的败血症。该菌株疑似产生 OXA 碳青霉烯酶（CARBA 试验阳性）、KPC（阴性）、MBL（阴性）。药敏试验表明对庆大霉素和黏菌素保持敏感性，对环丙沙星完全耐药。治疗方案再次修改，用黏菌素替代环丙沙星。
