■耐碳青霉烯鲍曼不动杆菌(CRAB)的感染是一种难以破解的难题。卡里霉素是一种新型重组大环内酯类抗生素,具有良好的体内抗感染作用。目前,很少报道用于治疗CRAB感染。我们介绍了一个病例,其中COVID-19合并CRAB感染的患者成功接受了包括carrimycin在内的联合治疗,提供临床见解和经验。
■感染CRAB的患者最终通过卡里霉素联合替加环素和阿米卡星治愈。分析总结治疗方案及疾病特点,为临床治疗提供参考。
■患者因发烧入院急诊观察病房,并被诊断为COVID-19肺炎。在治疗过程中,他的病情恶化了。他发烧了,咳嗽,还有咳痰.美罗培南经验性治疗3天后,通过下一代测序检测鲍曼不动杆菌感染呈阳性,在血液和痰培养中检测到CRAB。然后,他立即服用替加环素和阿米卡星5天,然而治疗效果并不显著。患者仍然处于高炎症反应中。最终,治疗方案改为卡里霉素联合替加环素和阿米卡星治疗7天,然后卡里霉素联合替加环素10天,患者的临床病情逐渐好转。患者接受了卡里霉素单药治疗7天,然后出院。
■作为联合治疗的药物之一,可望替代CRAB感染,尤其是在有高炎症反应的患者中。
UNASSIGNED: Infection with carbapenem-resistant Acinetobacter baumannii (
CRAB) is a tough nut to crack. Carrimycin is a novel recombinant macrolide antibiotic, and has good anti-infection effects in vivo. At present, it is rarely reported for treatment of
CRAB infection. We present a case where a patient with COVID-19 complicated by
CRAB infection was successfully treated with a combination therapy including carrimycin, offering clinical insights and experience.
UNASSIGNED: The patient infected with
CRAB was cured by carrimycin combined with tigecycline and amikacin ultimately. We analyzed and summarized the therapeutic regimen and disease feature to provide reference for clinical treatment.
UNASSIGNED: The patient was admitted to emergency observation wards with fever and was diagnosed with COVID-19 pneumonia. During the treatment, his condition worsened. He had a fever, cough, and expectoration. After 3 days of empirical treatment with meropenem, tested positive for A. baumannii infection by the next-generation sequencing, and CRAB was detected in blood and sputum culture. Then, he was administered with tigecycline and amikacin immediately for 5 days, however the therapeutic effect was not significant. The patient still remained in a high inflammatory response. Ultimately, the treatment regimen was changed to carrimycin combined with tigecycline and amikacin for 7 days, and then carrimycin combined with tigecycline for 10 days, the patient\'s clinical condition gradually improved. The patient received carrimycin monotherapy for 7 days, then discharged.
UNASSIGNED: Carrimycin may be a bright alternative for
CRAB infection as one of the drugs in combination therapy, especially in a patient with hyperinflammatory response.