Du Ning, You Dan, Tenzing Dava, Qu Dongxiang, Meng Jun, Wang Yihui, He Juan
Department of Pharmacy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, Guangdong Province, People's Republic of China.
Department of Pharmacy, The First Hospital of Qiqihar, Qiqihar, Heilongjiang Province, People's Republic of China.
Infect Drug Resist. 2024 Aug 19;17:3617-3621. doi: 10.2147/IDR.S468413. eCollection 2024.
Infection with carbapenem-resistant (CRAB) is a tough nut to crack. Carrimycin is a novel recombinant macrolide antibiotic, and has good anti-infection effects in vivo. At present, it is rarely reported for treatment of CRAB infection. We present a case where a patient with COVID-19 complicated by CRAB infection was successfully treated with a combination therapy including carrimycin, offering clinical insights and experience.
The patient infected with CRAB was cured by carrimycin combined with tigecycline and amikacin ultimately. We analyzed and summarized the therapeutic regimen and disease feature to provide reference for clinical treatment.
The patient was admitted to emergency observation wards with fever and was diagnosed with COVID-19 pneumonia. During the treatment, his condition worsened. He had a fever, cough, and expectoration. After 3 days of empirical treatment with meropenem, tested positive for infection by the next-generation sequencing, and CRAB was detected in blood and sputum culture. Then, he was administered with tigecycline and amikacin immediately for 5 days, however the therapeutic effect was not significant. The patient still remained in a high inflammatory response. Ultimately, the treatment regimen was changed to carrimycin combined with tigecycline and amikacin for 7 days, and then carrimycin combined with tigecycline for 10 days, the patient's clinical condition gradually improved. The patient received carrimycin monotherapy for 7 days, then discharged.
Carrimycin may be a bright alternative for CRAB infection as one of the drugs in combination therapy, especially in a patient with hyperinflammatory response.
耐碳青霉烯类鲍曼不动杆菌（CRAB）感染是一个难题。卡里霉素是一种新型重组大环内酯类抗生素，在体内具有良好的抗感染效果。目前，关于其治疗CRAB感染的报道较少。我们报告1例新型冠状病毒肺炎（COVID-19）合并CRAB感染患者，采用包括卡里霉素在内的联合治疗方案成功治愈，为临床提供见解和经验。
1例感染CRAB的患者最终采用卡里霉素联合替加环素及阿米卡星治愈。我们分析并总结治疗方案及疾病特点，为临床治疗提供参考。
患者因发热入住急诊观察病房，被诊断为COVID-19肺炎。治疗期间病情恶化，出现发热、咳嗽、咳痰。美罗培南经验性治疗3天后，下一代测序检测感染呈阳性，血及痰培养检出CRAB。随后立即给予替加环素及阿米卡星治疗5天，但治疗效果不显著，患者仍处于高炎症反应状态。最终，治疗方案改为卡里霉素联合替加环素及阿米卡星治疗7天，然后卡里霉素联合替加环素治疗10天，患者临床状况逐渐改善。患者接受卡里霉素单药治疗7天后出院。
作为联合治疗药物之一，卡里霉素可能是CRAB感染的一个不错选择，尤其是对于有高炎症反应的患者。
