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用头孢洛林治疗耐甲氧西林金黄色葡萄球菌菌血症引起的内源性眼内炎

Endogenous Endophthalmitis From Methicillin-Resistant Staphylococcus aureus Bacteremia Treated With Ceftaroline.

作者信息

Ho Daniel, Clayton Nicola A, Silverstein Bruce, Koff Alan

机构信息

Internal Medicine, University of California Davis Medical Center, Sacramento, USA.

Pharmacy, University of California Davis Medical Center, Sacramento, USA.

出版信息

Cureus. 2022 Feb 14;14(2):e22216. doi: 10.7759/cureus.22216. eCollection 2022 Feb.

Abstract

Methicillin-resistant  (MRSA) bacteremia may lead to endogenous endophthalmitis (EE), an uncommon disease process described mainly in case series and case reports. It is considered an ophthalmologic emergency requiring prompt diagnosis and treatment with systemic intravenous and intravitreal antibiotics to improve mortality and prevent blindness. The management of MRSA EE represents a challenge, as there are no established guidelines for treatment or outcomes. In our case report, we demonstrate that ceftaroline may be considered as an alternative option to treat MRSA EE in lieu of vancomycin due to drug-induced rash, given the promising penetration of the blood brain barrier and low minimum inhibitory concentration (MIC) values for most  isolates.

摘要

耐甲氧西林金黄色葡萄球菌(MRSA)菌血症可能导致内源性眼内炎(EE),这是一种主要在病例系列和病例报告中描述的罕见疾病过程。它被认为是一种眼科急症,需要迅速诊断并用全身静脉注射和玻璃体内注射抗生素进行治疗,以提高生存率并预防失明。MRSA EE的治疗是一项挑战,因为目前尚无既定的治疗指南或预后标准。在我们的病例报告中,我们证明,鉴于头孢洛林对血脑屏障有良好的穿透性且对大多数分离株的最低抑菌浓度(MIC)值较低,在因药物性皮疹而不能使用万古霉素的情况下,头孢洛林可被视为治疗MRSA EE的替代选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/11e9/8926881/8de5962c9e20/cureus-0014-00000022216-i01.jpg

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