VanDuyn Dylan C, Chadha Saloni, Paul Lauren A, Dressler Andrea R, Beccari Mario V, Bajwa Rajinder P S
D'Youville School of Pharmacy, Buffalo, NY, USA.
St. Bonaventure University, St. Bonaventure, NY, USA.
Hosp Pharm. 2022 Dec;57(6):767-770. doi: 10.1177/00185787221095767. Epub 2022 May 19.
Carbapenem-resistant Enterobacteriaceae (CRE) are problematic pathogens because infections caused by these organisms are associated with significant morbidity and mortality. These organisms often harbor multiple resistance mechanisms, which makes it difficult to treat their associated infections. Treatment typically consists of intravenous antibiotics that are selected based on the specific susceptibility pattern for the pathogen. Data on the use of oral antibiotics for the treatment of infections caused by CRE are sparse. In this case, a 62-year-old female presented with a chronic left leg wound infection. She previously underwent surgical debridement and skin grafting, which were unsuccessful. She was initially prescribed minocycline for the infection, but the wound got re-infected. At this time, the wound had significant surrounding erythema, drainage, and slough. A wound culture was obtained and demonstrated growth of carbapenem-resistant and methicillin-resistant . The patient was initiated on oral omadacycline, and she responded with resolution of the cellulitis and wound drainage. This case demonstrates that omadacycline may be beneficial as an oral medication for the treatment of complicated acute bacterial skin and skin structure infections caused by carbapenem-resistant .
耐碳青霉烯类肠杆菌科细菌(CRE)是有问题的病原体,因为这些微生物引起的感染与显著的发病率和死亡率相关。这些微生物常常具有多种耐药机制,这使得治疗它们相关的感染变得困难。治疗通常包括根据病原体的特定药敏模式选择静脉用抗生素。关于使用口服抗生素治疗CRE引起的感染的数据很少。在这个病例中,一名62岁女性因左腿慢性伤口感染就诊。她之前接受过手术清创和皮肤移植,但均未成功。最初她因感染被处方了米诺环素,但伤口再次感染。此时,伤口周围有明显的红斑、渗液和腐肉。进行了伤口培养,结果显示有耐碳青霉烯类和耐甲氧西林的细菌生长。患者开始口服奥马环素治疗,随后蜂窝织炎和伤口渗液消退。该病例表明,奥马环素作为口服药物,可能对治疗由耐碳青霉烯类细菌引起的复杂急性细菌性皮肤和皮肤结构感染有益。