Nafcillin加Ertapenem联合治疗持久性甲氧西林敏感卢顿葡萄球菌菌血症

Pub Date : 2023-07-01 DOI:10.1097/ipc.0000000000001277

I. Sharma, J. Hodges, S. Moonah, D. Shirley

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引用次数: 0

摘要

卢顿葡萄球菌是一种凝固酶阴性葡萄球菌，可引起类似金黄色葡萄球菌的严重感染。葡萄球菌菌血症患者对标准单一疗法没有反应，特别是在感染源控制不可行的情况下，治疗选择有限，这就需要改进协同抗生素组合来加强医疗管理。我们报告了一例58岁的患者，尽管使用了适当的萘呋西林治疗，但仍患有持续1周以上的卢顿假单胞菌菌血症。在加入厄他培南抢救疗法后，血液培养物成功灭菌，并在开始后2天内快速清除血液培养物。据我们所知，这是首次将厄他培南与抗双球菌青霉素联合使用来特异性清除持久性卢顿链球菌菌血症的报道。使用这种组合治疗甲氧西林敏感的金黄色葡萄球菌感染也取得了类似的成功；因此，我们的报告为这种组合治疗葡萄球菌感染的益处提供了进一步的支持。

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Clearance of Persistent Methicillin-Susceptible Staphylococcus lugdunensis Bacteremia Using Nafcillin Plus Ertapenem Combination Therapy

Staphylococcus lugdunensis is a coagulase-negative staphylococcus that can cause serious infection similar to Staphylococcus aureus. Limited therapeutic options are available for patients with staphylococcal bacteremia who fail to respond to standard monotherapy, particularly when source control of infection is not feasible, driving the need for improved synergistic antibiotic combinations to enhance medical management. We present the case of a 58-year-old patient with persistent S. lugdunensis bacteremia for over 1 week despite appropriate therapy with nafcillin. Blood cultures were successfully sterilized following the addition of ertapenem salvage therapy, with rapid blood culture clearance within 2 days of initiation. To our knowledge, this is the first report of using ertapenem in combination with an antistaphylococcal penicillin to specifically clear persistent S. lugdunensis bacteremia. Similar success has been reported using this combination to treat methicillin-susceptible S. aureus infections; hence, our report provides further support for the benefit of this combination for staphylococcal infections.

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