免疫功能低下儿童感染Cupriavidus gilardii的挑战:一个病例报告
Yue Hou1, Wenqin Xie1, Jinyue Duan1
1Department of Pediatrics, Zhujiang Hospital, Southern Medical University, Guangzhou, China.
Translational pediatrics
|January 8, 2026
概括
一种罕见的多药耐药 (MDR) 病原体Cupriavidus gilardii感染了一名免疫力低下的儿童. 塞法胺-阿维巴克坦 (CAZ-AVI) 显示为这种具有挑战性的格兰氏阴性感染的挽救疗法.
科学领域:
- 传染性疾病 传染性疾病
- 微生物学 微生物学
- 儿科瘤学 儿科瘤学
背景情况:
- 杯虫 (Cupriavidus gilardii) 是一种罕见的多药耐药 (MDR) 病原体,通常在土壤和水中发现.
- 人类感染非常罕见,对临床特征和有效的抗微生物策略的理解有限.
- 这一案例凸显了在严重免疫功能受损的儿科患者中管理C. gilardii的挑战.
研究的目的:
- 在患有急性淋巴细胞白血病的儿科患者中报告一种罕见的Cupriavidus gilardii感染病例.
- 为了评估ceftazidime-avibactam (CAZ-AVI) 作为MDR C. gilardii感染的救援疗法的临床疗效.
- 提供关于在免疫受损儿童中治疗不常见的格拉姆阴性细菌感染的见解.
主要方法:
- 一名患有急性淋巴细胞白血病的4岁男孩在化疗后出现了严重的免疫抑制.
- 最初的宽谱抗生素无效;诊断通过血液培养和元基因组下一代测序 (mNGS) 得到确认.
- 根据敏感性测试,治疗被调整为采胺-阿维巴克坦 (CAZ-AVI) 和tigecycline.
主要成果:
- 患者最初出现了败血性休克和呼吸困难,尽管经验性抗生素,情况恶化.
- 在切换到CAZ-AVI和tigecycline后,观察到显著的临床改善,减少炎症标志物和病原体清除.
- 尽管成功控制了细菌,但不幸的是,患者死于Aspergillus二次性肺动脉入侵.
结论:
- 塞法胺-阿维巴克坦 (CAZ-AVI) 在免疫功能低下的儿科患者中显示出作为对Cupriavidus gilardii感染的有效抗菌剂的潜力.
- 这一案例表明,CAZ-AVI可能会作为一种有价值的救援疗法,用于罕见的多药耐药格兰氏阴性细菌.
- 这些发现有助于理解和管理由具有挑战性的病原体引起的罕见儿科感染.
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