METHODS: A neonate born at 30 + 2 weeks gestation was admitted to the Neonatal Intensive Care Unit (NICU) after EG was detected in blood and cerebrospinal fluid cultures. Susceptibility testing indicated that the bacterial strain was resistant to vancomycin and sensitive to linezolid. Initially, vancomycin was selected for treatment. However, due to persistent EG cultures in the blood and cerebrospinal fluid, the treatment was adjusted to linezolid. This led to a rapid decrease in platelet (PLT) count, suspected to be an adverse reaction. Concurrently, the patient experienced recurrent fever and elevated inflammatory marker levels, prompting the discontinuation of linezolid and a return to vancomycin. Subsequent administration of vancomycin stabilized the patient\'s condition, as evidenced by improved C-reactive protein (CRP), procalcitonin (PCT), and cerebrospinal fluid parameters, ultimately leading to discharge after an eight-week treatment period.
CONCLUSIONS: This retrospective analysis highlights the efficacy of vancomycin in treating EG infections, suggesting that specific genetic phenotypes may influence treatment sensitivity. Monitoring vancomycin blood levels is crucial for determining treatment effectiveness.
方法:在血液和脑脊液培养中检测到EG后,将妊娠30+2周出生的新生儿送入新生儿重症监护病房(NICU)。药敏试验表明,该菌株对万古霉素耐药,对利奈唑胺敏感。最初,选择万古霉素进行治疗。然而,由于血液和脑脊液中持续的EG培养物,治疗调整为利奈唑胺.这导致血小板(PLT)计数迅速减少,怀疑是不良反应。同时,患者出现反复发热和炎症标志物水平升高,提示停止利奈唑胺和恢复万古霉素。随后服用万古霉素稳定了患者的病情,正如C反应蛋白(CRP)改善所证明的那样,降钙素原(PCT),和脑脊液参数,最终导致8周治疗后出院。
结论:本回顾性分析强调了万古霉素治疗EG感染的疗效,提示特定的遗传表型可能影响治疗敏感性。监测万古霉素血液水平对于确定治疗效果至关重要。