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头孢洛林酯成功治疗糖尿病患者的难治性甲氧西林敏感金黄色葡萄球菌骨髓炎

Successful Treatment of Refractory Methicillin-Sensitive Staphylococcus aureus Osteomyelitis With Ceftaroline Fosamil in a Diabetic Patient.

作者信息

Baroud Sarah, Alhammadi Fatima, Alhashimi Fatima, Elhaout Jawad, Al-Shakerchi Hasanain

机构信息

Internal Medicine, Mediclinic Parkview Hospital, Dubai, ARE.

Internal Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, ARE.

出版信息

Cureus. 2025 Jul 16;17(7):e88049. doi: 10.7759/cureus.88049. eCollection 2025 Jul.

DOI:10.7759/cureus.88049
PMID:40821271
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12355201/
Abstract

Osteomyelitis is a challenging complication in patients with diabetes mellitus, often necessitating prolonged antimicrobial therapy and surgical intervention. We present the case of a 70-year-old man with poorly controlled type 2 diabetes who developed recurrent diabetic foot osteomyelitis and vertebral osteomyelitis caused by methicillin-susceptible (MSSA). Despite receiving multiple courses of IV antibiotics and undergoing surgical debridement, the patient experienced persistent bacteremia without clinical improvement. Ceftaroline fosamil, a fifth-generation cephalosporin with activity against both MSSA and methicillin-resistant , was initiated. Following treatment, the patient achieved bacteriologic clearance and marked clinical improvement. This case underscores the potential role of ceftaroline in managing complex, refractory osteomyelitis, particularly when conventional therapies fail or are limited by resistance, adverse effects, or availability.

摘要

骨髓炎是糖尿病患者具有挑战性的并发症，常常需要长期抗菌治疗和手术干预。我们报告了一例70岁2型糖尿病控制不佳的男性患者，其发生了由甲氧西林敏感金黄色葡萄球菌（MSSA）引起的复发性糖尿病足骨髓炎和椎体骨髓炎。尽管接受了多疗程静脉抗生素治疗并进行了手术清创，但患者仍持续菌血症且无临床改善。于是开始使用头孢洛林酯，这是一种对MSSA和耐甲氧西林金黄色葡萄球菌均有活性的第五代头孢菌素。治疗后，患者实现了细菌学清除并取得了显著的临床改善。该病例强调了头孢洛林在治疗复杂难治性骨髓炎中的潜在作用，特别是在传统疗法失败或因耐药性、不良反应或可用性受限的情况下。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b3e/12355201/e8dcfb10c983/cureus-0017-00000088049-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b3e/12355201/786e980228e0/cureus-0017-00000088049-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b3e/12355201/47bf3d422017/cureus-0017-00000088049-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b3e/12355201/e8dcfb10c983/cureus-0017-00000088049-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b3e/12355201/786e980228e0/cureus-0017-00000088049-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b3e/12355201/47bf3d422017/cureus-0017-00000088049-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b3e/12355201/e8dcfb10c983/cureus-0017-00000088049-i03.jpg

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本文引用的文献

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Successful use of nafcillin and ceftaroline combination therapy for persistent MSSA bacteraemia and endocarditis: a case series.萘夫西林和头孢洛林联合治疗持续性甲氧西林敏感金黄色葡萄球菌菌血症和心内膜炎的成功应用：病例系列
JAC Antimicrob Resist. 2022 Dec 29;5(1):dlac129. doi: 10.1093/jacamr/dlac129. eCollection 2023 Feb.
2
Ceftaroline as salvage therapy for methicillin susceptible Staphylococcus aureus complicated bacteremia.头孢洛林作为治疗耐甲氧西林金黄色葡萄球菌合并菌血症的补救疗法。
Medicina (B Aires). 2022;82(5):794-797.
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The Golden Grapes of Wrath - Staphylococcus aureus Bacteremia: A Clinical Review.
《愤怒的金色葡萄球菌——金黄色葡萄球菌菌血症：临床综述》
Am J Med. 2023 Jan;136(1):19-26. doi: 10.1016/j.amjmed.2022.09.017. Epub 2022 Sep 28.
4
Ceftaroline: Systematic Review of Clinical Uses and Emerging Drug Resistance.头孢洛林：临床应用及新兴耐药性的系统评价。
Ann Pharmacother. 2022 Dec;56(12):1339-1348. doi: 10.1177/10600280221082326. Epub 2022 Mar 18.
5
Use of Ceftaroline Fosamil in Osteomyelitis: CAPTURE Study Experience.头孢洛林酯治疗骨髓炎的应用：CAPTURE 研究经验。
BMC Infect Dis. 2019 Feb 21;19(1):183. doi: 10.1186/s12879-019-3791-z.
6
Ceftaroline for the treatment of osteomyelitis caused by methicillin-resistant Staphylococcus aureus: a case series.头孢洛林治疗耐甲氧西林金黄色葡萄球菌引起的骨髓炎：病例系列
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Ceftaroline fosamil: a brief clinical review.头孢替唑钠：简要临床评价。
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