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使用头孢地尔治疗难治性耐药性脑室炎的临床治愈:病例报告及文献综述

Clinical Cure of a Difficult-to-Treat Resistant Ventriculitis Using Cefiderocol: A Case Report and Literature Review.

作者信息

Marcelo Cristina, de Gea Grela Alejandro, Palazuelos María Martínez, Veganzones Javier, Grandioso David, Díaz-Pollán Beatriz

机构信息

Infectious Disease Unit, Internal Medicine Department, La Paz Institute for Health Research, La Paz University Hospital, Madrid, Spain.

Internal Medicine Department, La Paz University Hospital, Madrid, Spain.

出版信息

Open Forum Infect Dis. 2022 Aug 1;9(8):ofac391. doi: 10.1093/ofid/ofac391. eCollection 2022 Aug.

Abstract

Ventriculitis is a complication of meningitis (community-acquired or nosocomial) or other central nervous system (CNS) infections such as brain abscess. They are associated with a different spectrum of microorganisms, from resistant gram-negative bacilli to staphylococci, that can lead serious illness with high mortality. Difficult-to-treat resistance (DTR) gram-negative bacilli may increase to 20% of deaths respective to susceptible isolates of the same bacteria. We present the first report of a clinical cured case of DTR ventriculitis in which cefiderocol penetration into the CNS has been confirmed in blood and cerebrospinal fluid. Cefiderocol might be considered for difficult-to-treat CNS infections in view of the recent new cases published as well as our case.

摘要

脑室炎是脑膜炎(社区获得性或医院获得性)或其他中枢神经系统(CNS)感染(如脑脓肿)的并发症。它们与不同种类的微生物有关,从耐药革兰氏阴性杆菌到葡萄球菌,这些微生物可导致严重疾病并具有高死亡率。与相同细菌的敏感菌株相比,难治疗耐药(DTR)革兰氏阴性杆菌导致的死亡可能增至20%。我们报告了首例DTR脑室炎临床治愈病例,其中已在血液和脑脊液中证实头孢地尔可穿透进入中枢神经系统。鉴于最近发表的新病例以及我们的病例,对于难治疗的中枢神经系统感染可考虑使用头孢地尔。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/372c/9379813/90eb5ea4979f/ofac391f1.jpg

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