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在高剂量达普素治疗期间,由于血液传播引起的VRE脑膜炎的发展

Srivani Sanikommu¹, Katherine Lusardi², Lyle Burdine³

¹Department of Internal Medicine, Division of Infectious Diseases, University of Arkansas for Medical Sciences, 4301 W Markham Slot #639, Little Rock, AR, USA72205-7101.

JAC-antimicrobial resistance

|November 29, 2023

概括

抗万科素的Enterococcus faecium (VRE) 脑膜炎很少见,尤其是在没有神经外科手术的情况下. 这一案例表明,在治疗VRE脑膜炎方面,特别是移植患者中,线索利德可能优于达普托米辛.

科学领域:

传染性疾病传染性疾病
神经外科神经外科
移植移植移植移植

背景情况:

抗万科素的Enterococcus faecium (VRE) 脑膜炎是一种罕见的并发症,通常与神经外科手术有关.
在细菌性脑膜炎病例中,VRE脑膜炎的发病率在0.3%至4.0%之间.
对VRE脑膜炎的最佳治疗策略尚不清楚.

研究的目的:

在没有神经外科干预的情况下报告肝移植接受者VRE脑膜炎的罕见病例.
为了评估达普托米辛和线索利德在治疗VRE脑膜炎中的疗效.
讨论对VRE中枢神经系统感染的潜在治疗偏好.

主要方法:

一个67岁的男性肝移植接受者的病例报告.
对VRE脑膜炎治疗高剂量达普托米辛,其次是linezolid的治疗反应的分析.
监测了临床和微生物学结果.

主要成果:

尽管没有进行神经外科手术,但患者通过血液传播发病了VRE脑膜炎.
高剂量的达普托米辛治疗未能解决VRE脑膜炎.
切换到linezolid导致症状迅速消失和微生物清除,并完全康复.

结论:

在实体器官移植接受者中,VRE感染存在重大风险.
有关VRE脑膜炎中达普素透到中枢神经系统存在担忧.
对于VRE中枢神经系统感染,线索利德可能是首选的治疗选择,而不是高剂量的达普托米辛.

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