替加环素鞘内注射治疗泛耐药鲍曼不动杆菌颅内感染1例报告及文献复习

Intrathecal injection of tigecycline in treatment of extensively drug-resistant Acinetobacter baumannii intracranial infection:one case report and literature review

1例患者经鼻行视神经减压术后发生泛耐药鲍曼不动杆菌颅内感染,给予静脉联合鞘内注射替加环素治疗,综合分析近五年相关文献,最终确定治疗方案。给予患者替加环素(首次100 mg,后续50 mg,q12h),联合头孢哌酮钠舒巴坦钠(3.0g,q8h)静脉滴注;替加环素2.5 mg,配伍5 mL生理盐水,q12h,腰大池引流管鞘内注射,夹闭2 h。鞘内注射替加环素15 d后患者连续4次脑脊液常规检查在正常范围,培养阴性,最终治愈。

One patient developed intracranial infection caused by extensively drug-resistant(XDR)Acinetobacter baumannii after intranasal endoscopic optic nerve decompression,intravenous combined intrathecal injection of tigecycline was given,treatment plan was finally determined through comprehensive analysis on relevant literatures in the past five years.Patient received intravenous drip of tigecycline(100 mg initially,followed by 50 mg,q12h)combined with cefoperazone sodium/sulbactam sodium(3.0 g,q8h);intrathecal injection of tigecycline 2.5 mg combined with 5 mL saline,q12h through lumbar cisterna drainage tube,clipping for 2 hours.After intrathecal injection of tigecycline for 15 days,four consecutive routine cerebrospinal fluid examination of patients were all within the normal limits,the culture result was negative,patient was finally cured.