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用头孢他啶-阿维巴坦治疗耐碳青霉烯类脊柱椎间盘炎:1例病例报告并文献复习

Carbapenem-Resistant Spondylodiscitis Treated with Ceftazidime-Avibactam: A Case Report with Literature Review.

作者信息

Danda Guilherme José da Nóbrega, Franco Andreia Craveiro, Gomes Elisangela Ana Paula, Montanaro Vinícius Vianna Abreu, Martins Bernardo José Alves Ferreira, Viana Bonan de Aguiar Vitor

机构信息

Department of Internal Medicine, SARAH Network of Rehabilitation Hospitals, Brasília, Federal District, Brazil.

Department of Microbiology, SARAH Network of Rehabilitation Hospitals, Brasília, Federal District, Brazil.

出版信息

Infect Drug Resist. 2023 Aug 14;16:5309-5317. doi: 10.2147/IDR.S421209. eCollection 2023.

Abstract

Pyogenic spondylodiscitis (PS) is a highly morbid and potentially fatal bacterial infection with an increasing incidence in recent decades. Its diagnosis and treatment are challenging, especially with the expansion of multidrug- or extensively drug-resistant bacteria. We report a rare case of PS caused by carbapenem-resistant (CRPA) that was treated with ceftazidime-avibactam (C/A). The choice of C/A therapy was based on the patient's bacterial sensitivity profile and intolerance to the initial therapeutic regimen (polymyxin B and meropenem). The total antimicrobial treatment time was seven weeks. The evolution of the clinical course met the cure criteria, which was characterized by remission of signs and symptoms, normalization of inflammatory markers, and radiological improvement over 18 months of clinical follow-up. This is a rare case of CRPA spondylodiscitis that responded to C/A treatment.

摘要

化脓性脊椎间盘炎(PS)是一种高致病性且可能致命的细菌感染,近几十年来发病率不断上升。其诊断和治疗具有挑战性,尤其是随着多重耐药或广泛耐药细菌的出现。我们报告了一例罕见的由耐碳青霉烯类肠杆菌科细菌(CRPA)引起的PS病例,该病例采用头孢他啶-阿维巴坦(C/A)进行治疗。选择C/A治疗是基于患者的细菌敏感性分析以及对初始治疗方案(多粘菌素B和美罗培南)的不耐受情况。抗菌治疗总时长为7周。临床病程进展符合治愈标准,其特征为体征和症状缓解、炎症标志物恢复正常,以及在18个月的临床随访中影像学表现有所改善。这是一例对C/A治疗有反应的罕见CRPA脊椎间盘炎病例。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e687/10438467/5d2550366868/IDR-16-5309-g0001.jpg

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