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静脉及脑室内注射硫酸粘菌素治疗多重耐药鲍曼不动杆菌所致中枢神经系统感染:一病例报告并文献复习
Authors Yang X, Guo C, Wu G, Zhao K, Xiang D, Xu D, Liu D, He Y
Received 11 June 2023
Accepted for publication 5 September 2023
Published 11 September 2023 Volume 2023:16 Pages 6029—6038
DOI https://doi.org/10.2147/IDR.S425415
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Prof. Dr. Héctor M Mora-Montes
Purpose: Due to the spread of antimicrobial-resistant bacteria and poor penetration of many antimicrobial drugs across the blood–brain barrier following intravenous administration, treatment of central nervous system (CNS) infections is challenging, especially infections caused by carbapenem-resistant organisms (CRO). Intraventricular (IVT) infusion of antimicrobial drugs could be a choice. This report aims to describe a patient with CNS infection caused by carbapenem-resistant Acinetobacter baumannii (CRAB) which was successfully treated with IVT combined with intravenous (IV) colistin sulfate.
Methods: A case of CNS infection caused by CRAB after a craniocerebral injury was presented. The patient was treated with IVT together with IV colistin sulfate. Moreover, literature on the regimens and safety of colistin sulfate were also reviewed and summarized.
Results: Intraventricular (50,000 U, qd/100,000 U, qd) combined with IV (500,000 U, q12h/500,000 U, q8h) colistin sulfate was given to the patient, and the CNS infection was successfully controlled. The patient was finally transferred back to a local hospital for rehabilitation treatment. No nephrotoxicity or neurotoxicity was observed during the therapy.
Conclusion: IV combined with IVT colistin sulfate is effective in the treatment of CNS infections caused by CRAB. IVT concomitant IV colistin sulfate might be a therapeutic option worth considering in the treatment of CNS infections caused by CRO.
Keywords: central nervous system infection, Acinetobacter baumannii , intraventricular administration, colistin sulfate, colistin, polymyxin