Tian Xia, Meng Xianbing, Guo Lichao, Li Yan, Gu Guoqing, Zhang Tianyan, An Rufeng
Department of Pharmacy, The Second Affiliated Hospital of Shandong First Medical University, Taian, Shandong 271000, P.R. China.
Department of Neurosurgery, The Second Affiliated Hospital of Shandong First Medical University, Taian, Shandong 271000, P.R. China.
Exp Ther Med. 2024 Dec 13;29(2):31. doi: 10.3892/etm.2024.12781. eCollection 2025 Feb.
Intracranial infection is a complication of neurosurgery that can lead to severe neurological complications, greatly increasing the risk of mortality. Intracranial infection caused by multidrug-resistant (MDR-AB) is one of the most severe complications of craniotomy. However, the availability of effective therapeutic options for such infections remains limited. Therefore, the present study aimed to assess the therapeutic efficacy of intrathecal/intracerebral (ITC) ventricle tigecycline injection for managing post-neurosurgical intracranial infections caused by MDR-AB. The present retrospective study was conducted from January 2014 to December 2023 at the Second Affiliated Hospital of Shandong First Medical University (Taian, China), which included 15 cases of MDR-AB positivity in the cerebrospinal fluid (CSF) cultures after neurosurgery. Patients treated with intravenous and intrathecal/ITC tigecycline ventricle injection were assigned to the 'ITV + ITC' group, whereas patients treated without intrathecal/ITC injection were assigned to the 'ITV' group. Data for general information, treatment history, the results of biochemical indicators in CSF and the microbiological clearance rate were collected and analyzed. No significant differences were observed in characteristics, susceptibility testing or empirical antimicrobial use between the two groups after treatment. However, after treatment, the ITV + ITC group exhibited a significantly decreased body temperature, whilst the biochemical indicators present in CSF were significantly improved. In addition, the ITV + ITC group had a significantly higher microbiological clearance rate (5/6; 83.33%) compared with that in the ITV group (2/9; 22.22%). These findings suggest that intravenous plus intrathecal/ITC ventricle injection of tigecycline is an effective regimen for treating intracranial infections caused by MDR-AB.
颅内感染是神经外科手术的一种并发症，可导致严重的神经并发症，大大增加死亡风险。耐多药鲍曼不动杆菌（MDR-AB）引起的颅内感染是开颅手术最严重的并发症之一。然而，针对此类感染的有效治疗方案仍然有限。因此，本研究旨在评估鞘内/脑室内（ITC）注射替加环素治疗MDR-AB引起的神经外科术后颅内感染的疗效。本回顾性研究于2014年1月至2023年12月在山东第一医科大学第二附属医院（中国泰安）进行，纳入了15例神经外科手术后脑脊液（CSF）培养中MDR-AB阳性的病例。接受静脉和鞘内/ITC脑室内注射替加环素治疗的患者被分配到“ITV + ITC”组，而未接受鞘内/ITC注射治疗的患者被分配到“ITV”组。收集并分析了一般信息、治疗史、CSF生化指标结果和微生物清除率的数据。治疗后两组在特征、药敏试验或经验性抗菌药物使用方面未观察到显著差异。然而，治疗后，ITV + ITC组体温显著下降，同时CSF中的生化指标显著改善。此外，ITV + ITC组的微生物清除率（5/6；83.33%）明显高于ITV组（2/9；22.22%）。这些结果表明，静脉联合鞘内/ITC脑室内注射替加环素是治疗MDR-AB引起的颅内感染的有效方案。
