1例脑出血患者术后疑似颅内感染龟分枝杆菌的药物治疗分析

Pharmacotherapy Analysis of One Case of Suspected Intracranial Infection Caused by Mycobacterium Chelonae After Cerebral Hemorrhage Operation

关键词:  龟分枝杆菌  颅内感染  药物治疗

Key words:  Mycobacterium chelonae  intracranial infection  pharmacotherapy

摘要:

目的 提高对颅内感染龟分枝杆菌的临床认识。方法 回顾性分析1例疑似龟分枝杆菌引起颅内感染的临床资料，并复习相关文献。结果 本例患者因脑出血术后手术切口感染继发颅内感染，经宏基因组新一代测序技术对脑脊液进行检测，疑似病原菌为龟分枝杆菌，结合病原学结果和药动学特点使用利奈唑胺治疗后病情有所好转。结论 龟分枝杆菌已成为继发于皮肤侵入性操作后重要的医院获得性感染致病菌，应引起临床和感控的高度重视，采取早识别、早控制的措施，以避免引起播散性感染，特别是治疗难度较大的颅内感染，并警惕潜在的医院内部传播风险。

Abstract:

OBJECTIVE To improve the clinical understanding of suspected intracranial infection of Mycobacterium chelonae. METHODS The clinical data of one case of suspected intracranial infection caused by Mycobacterium chelonae were retrospectively analyzed, and reviewed the literature. RESULTS The patient suffered from surgical incision infection and secondary intracranial infection after cerebral hemorrhage operation. The detection of cerebrospinal fluid by the metagenomics next-generation sequencing showed that the suspected pathogen was Mycobacterium chelonae. Combined with the etiological results and pharmacokinetic characteristics, the condition was improved after treatment with linezolid. CONCLUSION Mycobacterium chelonae has become an important nosocomial infection pathogen secondary to skin invasive operation. It should pay more attention to clinical and infection control, take early identification and control measures to avoid causing disseminated infection, especially intracranial infection which is difficult to treat, and should be alert to potential hospital transmission risk.