2025 , Vol. 11 >Issue 03: 323 - 328
DOI: https://doi.org/10.3877/cma.j.issn.2096-1537.2025.03.017
舒巴坦-度洛巴坦治疗造血干细胞移植后CRAB感染一例
通信作者:
陈辉,Email:1667187358@qq.comCopy editor: 卫轲
收稿日期: 2025-04-16
网络出版日期: 2026-01-15
版权
Sulbactam-Durlobactam for post-hematopoietic stem cell transplantation carbapenem-resistant Acinetobacter baumannii infection
Corresponding author:
Chen Hui, Email: 1667187358@qq.comReceived date: 2025-04-16
Online published: 2026-01-15
Copyright
本文报告1例67岁确诊骨髓增生异常综合征(MDS)男性患者行异基因造血干细胞移植(allo-HSCT)后发生碳青霉烯耐药鲍曼不动杆菌(CRAB)重症肺炎合并脓毒症,成功应用舒巴坦/度洛巴坦(SUL-DUR)治疗。患者移植术后出现发热、低氧血症、咳黄痰,胸部CT示双肺多发间质性炎症伴实变,多次痰培养及血液宏基因组二代测序技术均检出CRAB。初期多黏菌素B、美罗培南、依拉环素等多线联合疗法无明显改善,继而启用SUL-DUR联合方案,并配合免疫调节和气道管理,炎症指标(C反应蛋白、降钙素原)迅速下降,病原学转阴,患者脱机成功并转入普通病房。提示SUL-DUR联合方案在免疫抑制CRAB重症感染患者中疗效显著、安全性良好,为血液移植患者复杂感染的抗菌治疗提供新选择。
关键词: 碳青霉烯耐药鲍曼不动杆菌; 异基因造血干细胞移植; 舒巴坦/度洛巴坦
何增柱 , 陈辉 . 舒巴坦-度洛巴坦治疗造血干细胞移植后CRAB感染一例[J]. 中华重症医学电子杂志, 2025 , 11(03) : 323 -328 . DOI: 10.3877/cma.j.issn.2096-1537.2025.03.017
We reported a 67-year-old man with myelodysplastic syndrome who developed carbapenem-resistant Acinetobacter baumannii (CRAB)-induced severe pneumonia and sepsis after allogeneic hematopoietic stem cell transplantation. Post-transplantation, he presented with fever, hypoxemia and productive yellow sputum; chest CT showed bilateral diffuse interstitial inflammation with areas of consolidation. Repeated sputum cultures and blood metagenomic next-generation sequencing confirmed CRAB infection. Initial multidrug regimens - including polymyxin B, meropenem and eravacycline - failed to achieve clinical improvement. A Sulbactam-Durlobactam (SUL-DUR)-based combination regimen was then introduced, along with immunomodulatory therapy and airway management. Inflammatory markers (CRP and PCT) decreased rapidly, pathogens were eradicated, and the patient was successfully weaned from mechanical ventilation and transferred to the general ward. This case suggested that SUL-DUR-based therapy was both effective and well-tolerated for severe CRAB infections during immune reconstitution, and offered a promising therapeutic option for complex post-transplant infections.
何增柱, 陈辉. 舒巴坦-度洛巴坦治疗造血干细胞移植后CRAB感染一例[J/OL]. 中华重症医学电子杂志, 2025, 11(3): 323-328.
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