临床药师参与1例全身多部位泛耐药鲍曼不动杆菌感染患者的治疗
詹世鹏;唐敏;何菊英;
摘要(Abstract):
目的探讨泛耐药鲍曼不动杆菌(XDR-AB)感染的治疗方案及临床药师在重症感染病例救治中的作用。方法以1例全身多部位(皮肤、肺部、颅内、血液)感染XDR-AB的患者为例,介绍临床药师根据患者病情变化协助医师制定抗感染治疗方案,分析并讨论XDR-AB的防控与治疗。结果患者的感染得到有效控制,治疗过程中无明显药物不良反应发生。结论以多黏菌素(鞘内+静滴)为基础的联合治疗方案可能是治疗XDR-AB颅内、血流感染的有效方案。加强感染防控,探索和优化抗感染治疗策略,加强多学科的协作,对提高治愈率有重要意义。
关键词(KeyWords): 耐药鲍曼不动杆菌;颅内感染;多黏菌素
基金项目(Foundation):
作者(Authors): 詹世鹏;唐敏;何菊英;
DOI: 10.19577/j.cnki.issn10074406.2017.04.013
参考文献(References):
- [1]GIAMARELLOU H,ANTONIADOU A,KANELLAKOPOULOU K.Acinetobacter baumannii:a universal threat to public health[J].Int J Antimicrob Agents,2008,32(2):106.
- [2]MUNOZ-PRICE LS,WEINSTEIN RA.Acinetobacter infection[J].N Engl J Med,2008,358(12):1271.
- [3]张银维,周华,蔡洪流,等.鲍曼不动杆菌血流感染临床特征和死亡危险因素分析[J].中华内科杂志,2016,55(02):121.
- [4]KIM BN,PELEG AY,LODISE TP,et al.Management of meningitis due to antibiotic-resistant Acinetobacter species[J].Lancet Infect Dis,2009,9(4):245.
- [5]胡付品,朱德妹,汪复,等.2013年中国CHINET细菌耐药性监测[J].中国感染与化疗杂志,2014,14(5):365.
- [6]陈佰义,何礼贤,胡必杰,等.中国鲍曼不动杆菌感染诊治与防控专家共识[J].中华医学杂志,2012,92(2):76.
- [7]JIMNEZ-MEJAS ME,PICHARDO-GUERRERO C,MRQUEZRIVAS FJ,et al.Cerebrospinal fluid penetration and pharmacokinetic/pharmacodynamic parameters of intravenously administered colistin in a case of multidrug-resistant Acinetobacter baumannii meningitis[J].Eur J Clin Microbiol Infect Dis,2002,21(3):212.
- [8]KARAISKOS I,GALANI L,BAZIAKA F,et al.Intraventricular and intrathecal colistin as the last therapeutic resort for the treatment of multidrug-resistant and extensively drug-resistant Acinetobacter baumannii ventriculitis and meningitis:a literature review[J].Int J Antimicrob Agents,2013,41(6):499.
- [9]De BONIS P,LOFRESE G,SCOPPETTUOLO G,et al.Intraventricular versus intravenous colistin for the treatment of extensively drug resistant Acinetobacter baumannii meningitis[J].Eur J Neurol,2016,23(1):68.
- [10]谢兵,王伟民,梁军潮.术后颅内鲍曼不动杆菌感染的治疗经验[J].中华神经外科杂志,2013,29(2):188.
- [11]TUNKEL AR,HARTMAN BJ,KAPLAN SL,et al.Practice guidelines for the management of bacterial meningitis[J].Clin Infect Dis,2004,39(9):1267.
- [12]BASSETTI M,REPETTO E,RIGHI E,et al.Colistin and rifampicin in the treatment of multidrug-resistant Acinetobacter baumannii infections[J].J Antimicrob Chemother,2008,61(2):417.
- [13]MOTAOUAKKIL S,CHARRA B,HACHIMI A,et al.Colistin and rifampicin in the treatment of nosocomial infections from multiresistant Acinetobacter baumannii[J].J Infect,2006,53(4):274.