多重耐药鲍曼不动杆菌颅内感染治疗一例

Treatment of multidrug-resistant Acinetobacter baumannli intracranial infection:a case report

本文通过对1例行巨大听神经瘤切除术后多重耐药鲍曼不动杆菌(MDRAB)颅内感染患者的抗感染治疗过程进行回顾性分析,讨论了该类患者的药物治疗方案和药学监护要点。患者经内镜下清理颅内菌斑及沉积物,植入双侧Ommaya囊,高剂量美罗培南联合替加环素静脉给药,合并替加环素脑室内注射治疗后好转,治疗过程中未出现不能耐受的药物不良反应,治疗效果良好。因此,感染灶控制结合替加环素脑室内注射可以有效治疗多重耐药鲍曼不动杆菌中枢神经系统感染,本方案有望为临床治疗增加更多的选择。

Through a retrospective analysis of the anti-infective treatment process of a patient with multidrug-resistant Acinetobacter baumannii intracranial infection after resection of a giant acoustic neuroma,discussed the drug treatment regimen and pharmaceutical care points for this type of infection. The patient underwent endoscopic cleaning of intracranial plaque and deposits,implanted bilateral Ommaya reservoir,intravenous administration of high-dose meropenem and tigecycline,combined with intraventricular injection of tigecycline. There were no intolerable adverse drug reactions,and the patient was cured. Therefore,resource control combined with intraventricular injection of tigecycline can effectively treat multidrug-resistant Acinetobacter baumannii central nervous system infections,and this method is expected to add more options for clinical treatment of difficult-to-treated intracranial infection.