Zhou Shuang, Xin Chengqi, Liu Wenjuan
Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, People's Republic of China.
Stem Cell Clinical Research Center, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, People's Republic of China.
Infect Drug Resist. 2025 Jan 13;18:253-260. doi: 10.2147/IDR.S502839. eCollection 2025.
is a common pathogen of hematogenous lung abscesses. The increased resistance of to antibiotics makes infections difficult to treat, often resulting in a poor prognosis. Therefore, it is important to identify infections as early as possible and evaluate its sensitivity and resistance to antibiotics, to formulate an appropriate treatment plan. Oxazolidinone antibiotics exhibit potent antibacterial activity against multidrug-resistant (MDR) ; however, the adverse effects of linezolid, particularly thrombocytopenia, limit its application. Contezolid may ameliorate the hematologic toxicity associated with linezolid. Here, we report the case of a patient with congenital cerebral hypoplasia who was hospitalized due to fever and multiple abscesses in both lungs. In the context of negative blood culture results, the final diagnosis of MDR as the causative agent of hematogenous lung abscess was confirmed using macrogenomic next-generation sequencing (mNGS) and targeted next-generation sequencing (tNGS). The patient was treated with linezolid but developed significant thrombocytopenia, so switching to sequential therapy with contezolid, the patient's platelet counts returned to normal and his condition improved significantly.
是血源性肺脓肿的常见病原体。其对抗生素的耐药性增加使得感染难以治疗,常常导致预后不良。因此,尽早识别感染并评估其对抗生素的敏感性和耐药性,以制定合适的治疗方案非常重要。恶唑烷酮类抗生素对多重耐药(MDR)表现出强大的抗菌活性;然而,利奈唑胺的不良反应,尤其是血小板减少症,限制了其应用。康替唑胺可能会改善与利奈唑胺相关的血液学毒性。在此,我们报告一例先天性脑发育不全患者,该患者因发热和双肺多发脓肿住院。在血培养结果为阴性的情况下,通过宏基因组下一代测序(mNGS)和靶向下一代测序(tNGS)确诊MDR为血源性肺脓肿的病原体。该患者接受利奈唑胺治疗,但出现了明显的血小板减少症,因此改用康替唑胺序贯治疗,患者的血小板计数恢复正常,病情明显改善。