第一个小儿病例成功地用Cefiderocol治疗了IMP类型的卡巴酶产生的Enterobacterales细菌病
Haruna Mori1, Yuto Otsubo2, Meiwa Shibata2
1Division of Neonatology, Department of Intensive Care, Tokyo Metropolitan Children's Medical Center, 2-8-29 Musashidai, Fuchu, Tokyo, 183-8561, Japan.
概括
这是首个成功使用Cefiderocol治疗IMP型Klebsiella pneumoniae引起的卡巴酶生成肠杆菌 (CPE) 细菌病的儿科病例. 抗生素联合治疗有效地清除了一个年轻患者的感染.
科学领域:
- 传染性疾病 传染性疾病
- 儿科 儿科 儿科
- 抗微生物耐药性 抗微生物耐药性
背景情况:
- 生产碳酶的肠道细菌 (CPE) 构成了全球严重的健康威胁.
- 塞菲德罗科尔在体外显示出对各种CPE的活性,但临床数据,特别是对儿科患者的临床数据,对于IMP型CPE是有限的.
- 由于治疗选择有限,IMP型CPE感染的治疗具有挑战性.
研究的目的:
- 报告第一个成功的儿科病例,用于治疗IMP型CPE细菌血症的Cefiderocol.
- 评估Cefiderocol在治疗具有复杂病史和IMP型CPE感染的儿科患者中的疗效和安全性.
主要方法:
- 一名6岁的男孩患有遗传性甘酸酸氨基醇缺乏症和急性淋巴细胞白血病,患有细菌病.
- 血培养多重PCR确定了携带IMP基因的Klebsiella肺炎.
- 治疗涉及使用 cefiderocol 和 gentamicin 进行组合治疗,随后进行 cefiderocol 单一治疗.
主要成果:
- 组合疗法成功消毒了血液培养物.
- 分子测试揭示了分离物产生的IMP-1碳酶,SHV扩展谱β-乳糖酶和EBC型AmpCβ-乳糖酶.
- 在0.5μg/mL的最小抑制度下,Cefiderocol表现出敏感性.
结论:
- 塞菲德罗科尔可以成为小儿IMP型CPE细菌血症的有效治疗选择.
- 这一案例凸显了塞菲德罗科尔在治疗儿童具有挑战性的格兰氏阴性感染方面的潜力.
- 需要进一步的研究,以制定关于在儿科IMP型CPE感染中使用Cefiderocol的最终指南.
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