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耐碳青霉烯类肠杆菌科细菌(CRE)所致神经外科术后脑室炎和脑膜炎的治疗:一个具有挑战性的课题。

Treatment of Ventriculitis and Meningitis After Neurosurgery Caused by Carbapenem-Resistant (CRE): A Challenging Topic.

作者信息

Li Cuiling, Zhou Peng, Liu Yuanqin, Zhang Lei

机构信息

Department of Neurosurgery, Shandong Medicine and Health Key Laboratory of Neurosurgery, The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Jinan, People's Republic of China.

出版信息

Infect Drug Resist. 2023 Jun 15;16:3807-3818. doi: 10.2147/IDR.S416948. eCollection 2023.

Abstract

Post-neurosurgical infection is a common complication of neurosurgery, and serious infection can threaten the life of patients. In recent years, the increase in multidrug-resistant bacteria, especially carbapenem-resistant (CRE), has proved fatal to patients. Although there are a few cases of CRE meningitis and few clinical trials have been carried out, it has attracted increasing attention with the increasing probability of its occurrence, especially considering that there are few successful cases. An increasing number of studies are also looking for the risk factors and clinical symptoms of CRE intracranial infection. In terms of treatment, some new antibiotics are gradually being used in the clinic, but due to the complicated drug-resistant mechanism of CRE and the obstruction of the blood‒brain barrier (BBB), the therapeutic effect is still very poor. In addition, obstructive hydrocephalus and brain abscess caused by CRE meningitis are still important causes of patient death and are also difficult to treat.

摘要

神经外科术后感染是神经外科常见的并发症,严重感染会威胁患者生命。近年来,多重耐药菌尤其是耐碳青霉烯类肠杆菌科细菌(CRE)的增多已被证实对患者是致命的。尽管有少数CRE脑膜炎病例且开展的临床试验较少,但随着其发生概率的增加,尤其是考虑到成功治疗的病例很少,它已引起越来越多的关注。越来越多的研究也在探寻CRE颅内感染的危险因素和临床症状。在治疗方面,一些新型抗生素正逐渐在临床上使用,但由于CRE耐药机制复杂以及血脑屏障(BBB)的阻碍,治疗效果仍然很差。此外,CRE脑膜炎引起的梗阻性脑积水和脑脓肿仍是患者死亡的重要原因,且治疗也很困难。

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