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[支架相关性泌尿道感染,个性化噬菌体疗法]

[Stent-associated urosepsis, personalized bacteriophage therapy].

作者信息

Perepanova T S, Kazachenko A V, Mesropyan S A, Antonova V E, Nazirov M R, Malova Yu A, Lyubchenko L N

机构信息

N.A. Lopatkin Research Institute of Urology and Interventional Radiology branch of the National Medical Research Radiological Center, Moscow, Russia.

出版信息

Urologiia. 2024 Sep(4):97-102.

Abstract

In the era of antibiotic resistance, strict control of foci of infection (for example, a long-term stent) and adherence to the timing of drainage removal are necessary. The spread of pan-resistant pathogens requires the development of effective alternative antimicrobial measures, in particular, bacteriophage therapy. A clinical case of a 42-year-old patient with a closed spinal cord injury, lower paraplegia, pelvic organs dysfunction, post-traumatic right ureteral stricture, and right kidney stones is presented in the article. The patient developed stent-associated urosepsis due to pan-resistant Klebsiella pneumonia after endoscopic removal of a long-term right ureteral stent (over 3 months) with endotoxic shock, disseminated intravascular coagulation syndrome and wound sepsis, which was treated using personalized local bacteriophage therapy.

摘要

在抗生素耐药性的时代,严格控制感染病灶(例如长期支架)并严格遵守引流管拔除时间是必要的。泛耐药病原体的传播需要开发有效的替代抗菌措施,特别是噬菌体疗法。本文介绍了一名42岁患者的临床病例,该患者患有闭合性脊髓损伤、下半身截瘫、盆腔器官功能障碍、创伤后右输尿管狭窄和右肾结石。患者在通过内镜取出长期(超过3个月)的右输尿管支架后,因泛耐药肺炎克雷伯菌发生了支架相关性泌尿道感染,并伴有内毒素休克、弥散性血管内凝血综合征和伤口感染,采用个性化局部噬菌体疗法进行了治疗。

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