神经外科术后泛耐药鲍曼不动杆菌颅内感染患儿一例

doi:10.3877/cma.j.issn.2096-1537.2024.02.017

中华重症医学电子杂志 ›› 2024, Vol. 10 ›› Issue (02) : 205 -208. doi: 10.3877/cma.j.issn.2096-1537.2024.02.017

病例报告

神经外科术后泛耐药鲍曼不动杆菌颅内感染患儿一例

邓小鹿¹, 赵杰², 李健², 李春辉³, 何剑¹, 司道林¹, 王霞¹^,^†(

)

^1. 410008　长沙，中南大学湘雅医院儿科
^2. 410008　长沙，中南大学湘雅医院神经外科
^3. 410008　长沙，中南大学湘雅医院感染控制中心

收稿日期:2023-04-27 出版日期:2024-05-28
通信作者: 王霞

Post-neurosurgical intracranial infections caused by extensively drug-resistant Acinetobacter baumannii in a pediatric patient: a case report

Xiaolu Deng¹, Jie Zhao², Jian Li², Chunhui Li³, Jian He¹, Daolin Si¹, Xia Wang¹^,^†()

^1. Department of Pediatrics, Xiangya Hospital, Central South University, Changsha 410008, China
^2. Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha 410008, China
^3. Infection Control Center, Xiangya Hospital, Central South University, Changsha 410008, China

Received:2023-04-27 Published:2024-05-28
Corresponding author: Xia Wang

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医疗相关脑室炎和脑膜炎（HCAVM）与神经外科手术密切相关。HCAVM最常由革兰氏阳性菌引起，但近年革兰氏阴性菌感染呈现上升趋势。广泛耐药（XDR）革兰氏阴性菌所致的颅内感染可导致严重的后遗症，病死率高。本文报道1例神经外科术后XDR鲍曼不动杆菌脑室炎患者，通过多学科合作治愈，以期为类似疾病的成功诊治提供经验。

关键词: 颅内感染, 泛耐药, 鲍曼不动杆菌, 多黏菌素

Healthcare-Associated Ventriculitis and Meningitis (HCAVM) are closely related to neurosurgery. HCAVM is most commonly caused by gram-positive bacteria, but gram-negative infections have been on the rise in recent years. Intracranial infection caused by extensively drug-resistant (XDR) gram-negative bacteria leads to serious sequelae and high mortality. We reported that a pediatric patient with XDR Acinetobacter baumannii ventriculitis after neurosurgery was cured through multidisciplinary cooperation, in order to provide experience for the successful diagnosis and treatment of similar diseases.

Key words: Intracranial infection, Extensively drug-resistant, Acinetobacter baumannii, Polymyxin

图1 广泛耐药鲍曼不动杆菌脑室炎患者头颅磁共振成像。图a，b为起病后28 d（即入院后第6天），左侧脑室及后角旁积血，图c，d为脑脓肿清除术后1周复查，左侧脑室及后角旁积血吸收，脑积水并间质性脑水肿

图2 广泛耐药鲍曼不动杆菌脑室炎患者脑室镜下脑室内组织碎片和脓苔

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