对神经脑膜感染的抗生素治疗
Yves Gillet1, Emmanuel Grimprel2, Hervé Haas3
1Pediatric Emergency and Infectious Disease, Hôpital Femme Mère Enfant, Lyon, France; Pediatric Infectious Pathology Group of the French Pediatric Society, France.
Infectious diseases now
|September 23, 2023
概括
结合性肺炎球菌疫苗接种在法国减少了脑膜炎病例. 目前的指导方针建议限制肺炎球菌脑膜炎的万科米辛,并更新对大肠杆菌脑膜炎的抗生素策略.
科学领域:
- 传染性疾病 传染性疾病
- 儿科 儿科 儿科
- 微生物学 微生物学
背景情况:
- 结合性肺炎球菌疫苗接种在法国显著改变了肺炎球菌脑膜炎的流行病学.
- 已经观察到高毒性,抗beta-lactam的抗菌株的消除.
- 在2021年注意到较不有利的肺炎球菌样本的出现.
研究的目的:
- 根据当前的流行病学数据,更新肺炎球菌脑膜炎的治疗建议.
- 改进儿童细菌脑膜炎的抗生素策略.
- 为管理社区获得的大脑提供指导.
主要方法:
- 来自全国儿科脑膜炎网络 (儿科传染病组 - GPIP) 和国家肺炎菌参考中心的数据分析.
- 对15年来流行病监测数据的审查.
- 对抗生素敏感性概况和治疗结果的评估.
主要成果:
- 最近没有记录过由于第三代抗素 (C3G) 耐药性 * 肺炎 estreptococcus * 的脑膜炎病例.
- 只有在MIC对注射C3G>0.5 mg/L时,才建议在二次治疗阶段使用万科米辛.
- 在新生儿和婴儿中停止治疗 * Escherichia coli * 脑膜炎的西普罗夫洛克萨和塞福塔キシ姆组合.
结论:
- 更新的建议支持限制万科米辛和修订的抗生素治疗方案.
- 持续的流行病学监测对于调整疗法以适应不断变化的病原体易感性至关重要.
- 大脑的治疗需要及时的成像,抗生素前取样以及特定的抗生素组合 (美特罗尼达,塞福他辛).
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