脑室内联合全身抗生素治疗多粘菌素耐药性脑室炎：病例报告

Intraventricular Plus Systemic Antibiotic Therapy for Treating Polymyxin-Resistant Ventriculitis: A Case Report.

作者信息

Wang Hao, Zhou Qian, Huang Kaiyuan, Yang Xiaofeng, Wen Liang

机构信息

Department of Neurosurgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China.

Department of Emergency and Trauma Center, The International Medical Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China.

出版信息

Open Forum Infect Dis. 2022 Feb 15;9(4):ofac084. doi: 10.1093/ofid/ofac084. eCollection 2022 Apr.

BACKGROUND

Treating central nervous system (CNS) infections caused by extensively drug-resistant (XDR) gram-negative bacilli, such as carbapenem-resistant , represents a significant clinical challenge. Polymyxin is occasionally used as a salvage treatment for this severe CNS infection. We report here a rare case of polymyxin-resistant ventriculitis, which was successfully treated with ventricular injections and intravenous antibiotics.

METHODS

A 53-year-old male underwent a decompressive craniectomy and was referred to our hospital with cerebrospinal fluid incisional leakage and persistent fever.

RESULTS

The minimum inhibitory concentration of polymyxin B in this patient increased from 2 to 4 μg/mL during the course of treatment. He was diagnosed with polymyxin-resistant XDR ventriculitis. We successfully treated the infection with intravenous ceftazidime/avibactam (CAZ/AVI) combined with ventricular injection of tigecycline according to cerebrospinal fluid microbiological culture.