Hong Xiao-Bing, Yu Ze-Lin, Fu Hong-Bo, Cai Ze-Hong, Chen Jie
Department of Pharmacy, The Second Affiliated Hospital of Shantou University of Medical College, Shantou 515041, Guangdong Province, China.
Department of Pharmacology, Shantou University Medical College, Shantou 515041, Guangdong Province, China.
World J Clin Cases. 2022 Mar 16;10(8):2550-2558. doi: 10.12998/wjcc.v10.i8.2550.
Vancomycin remains a first-line treatment drug as per the treatment guidelines for methicillin-resistant (MRSA) bacteremia. However, a number of gram-positive cocci have developed resistance to several drugs, including glycopeptides. Therefore, there is an urgent need for effective and innovative antibacterial drugs to treat patients with infections caused by drug-resistant bacteria.
A 24-year-old male was admitted to hospital owing to lumbago, fever, and hematuria. Computed tomography (CT) results showed an abscess in the psoas major muscle of the patient. Repeated abscess drainage and blood culture suggested MRSA, and vancomycin was initiated. However, after day 10, CT scans showed abscesses in the lungs and legs of the patient. Therefore, treatment was switched to daptomycin. Linezolid was also added considering inflammation in the lungs. After 10 d of the dual-drug anti-MRSA treatment, culture of the abscess drainage turned negative for MRSA. On day 28, the patient was discharged without any complications.
This case indicates that daptomycin combined with linezolid is an effective remedy for bacteremia caused by MRSA with pulmonary complications.
根据耐甲氧西林金黄色葡萄球菌（MRSA）菌血症的治疗指南，万古霉素仍然是一线治疗药物。然而，许多革兰氏阳性球菌已对包括糖肽类在内的多种药物产生耐药性。因此，迫切需要有效且创新的抗菌药物来治疗耐药菌感染的患者。
一名24岁男性因腰痛、发热和血尿入院。计算机断层扫描（CT）结果显示该患者腰大肌有脓肿。反复的脓肿引流和血培养提示为MRSA，遂开始使用万古霉素治疗。然而，在第10天后，CT扫描显示患者肺部和腿部出现脓肿。因此，治疗改为使用达托霉素。考虑到肺部炎症，还加用了利奈唑胺。经过10天的双药抗MRSA治疗后，脓肿引流培养结果显示MRSA转为阴性。在第28天，患者无任何并发症出院。
该病例表明，达托霉素联合利奈唑胺是治疗伴有肺部并发症的MRSA菌血症的有效疗法。
