1例急性B淋巴细胞白血病伴耐碳青霉烯解鸟氨酸拉乌尔菌败血症的治疗并文献复习

Treatment and Literature Review of One Case of Acute B Lymphoblastic Leukemia with Carbapenem-Resistant Raoultella ornithinolytica Sepsis

目的:探讨急性白血病伴解鸟氨酸拉乌尔菌败血症的临床特点、诊断及治疗,提高对该细菌的认识。方法:回顾1例急性B淋巴细胞白血病(B-ALL)伴耐碳青霉烯解鸟氨酸拉乌尔菌感染病人的临床资料,分析其临床特点并复习相关文献。结果:结合患者的临床资料及辅助检查,诊断为B-ALL化疗后伴耐碳青霉烯的解鸟氨酸拉乌尔菌败血症,给予以头孢他啶/阿维巴坦(CAZ/AVI)为主的联合抗感染、促造血、输血、保肝等治疗,患者病情好转。结论:以CAZ/AVI为主的联合方案可能是治疗耐碳青霉烯的解鸟氨酸拉乌尔菌引起的血液感染和皮肤感染的有效选择。

Objective: To investigate the clinical features, diagnosis and treatment of acute leukemia with Ra-oultella ornithinolytica sepsis, and to improve the understanding of this bacterium. Methods: To re-view the clinical data of a case of acute B-lymphoblastic leukemia (B-ALL) with carbapenem- re-sistant Raoultella ornithinolytica infection, analyze its clinical characteristics and review the rele-vant literature. Results: Combined with the patient’s clinical data and auxiliary examination, the patient was diagnosed as B-ALL chemotherapy with carbapenem-resistant Raoultella ornithinolyti-ca sepsis. The patient was given ceftazidime/avibactam (CAZ/AVI) combined with anti-infection, hematopoietic promotion, blood transfusion, liver protection and other treatments, and the pa-tient’s condition improved. Conclusion: CAZ/AVI based combination regimen may be an effective choice for the treatment of blood and skin infections caused by carbapenem-resistant Raoultella or-nithinolytica.