鞘内注射联合静脉滴注多黏菌素B治疗广泛耐药鲍曼不动杆菌致化脓性脑膜炎1例

Intrathecal injection combined with intravenous instill of polymyxin B in the treatment of extensively drug-resistant Acinetobacter baumannii induced purulent meningitis: a case report

目的 探讨多黏菌素B治疗广泛耐药鲍曼不动杆菌所致颅内感染的疗效。方法 回顾性分析广泛耐药鲍曼不动杆菌致化脓性脑膜炎病例1例,查阅文献分析多黏菌素B鞘内注射在颅内感染治疗中的作用。结果 患者因脑出血术后并发颅内感染,脑脊液培养检出广泛耐药鲍曼不动杆菌,给予多黏菌素B静脉滴注加鞘内注射,先后联合替加环素、左氧氟沙星等抗感染治疗1月余,脑脊液复查无菌生长,患者出院继续口服药物抗感染治疗。患者半月后入院复查,病情控制稳定。结论 鞘内注射联合静脉滴注多黏菌素B,可以作为广泛耐药鲍曼不动杆菌所致化脓性脑膜炎的一种有效治疗方案。

Objective To investigate the efficacy of polymyxin B in the treatment of intracranial infection caused by extensively drug-resistant Acinetobacter baumannii.Methods A case of purulent meningitis caused by extensively drug-resistant Acinetobacter baumannii was analyzed retrospectively. The role of intrathecal injection of polymyxin B in the treatment of intracranial infection was analyzed by consulting the literature. Results The patient was complicated with intracranial infection after intracerebral hemorrhage operation. Acinetobacter baumannii with extensively drug resistance was detected in cerebrospinal fluid culture. Polymyxin B was given intravenous drip and intrathecal injection, combined with tigecyclin and levofloxacin for anti-infection treatment for more than 1 month. The cerebrospinal fluid was rechecked for sterile growth, and the patient continued oral administration of drugs for anti infection treatment. Half a month later, the patient was admitted to the hospital for reexamination, and the condition was stable.Conclusions Intrathecal injection combined with intravenous drip of polymyxin B could be used as an effective treatment for purulent meningitis caused by extensively drug-resistant Acinetobacter baumannii.