多重耐药草绿色链球菌脑膜炎合并菌血症抗感染用药分析

摘要

目的 探讨多重耐药草绿色链球菌脑膜炎合并菌血症的抗感染治疗方案.方法 通过临床药师参与1例多重耐药草绿色链球菌脑膜炎合并菌血症的抗感染治疗,探讨细菌耐药机制,总结治疗方案.结果 对于多重耐药草绿色链球菌脑膜炎合并菌血症,尽早获得脑脊液培养和血液培养结果,并结合脑脊液涂片、常规、生化是诊断草绿色链球菌脑膜炎的金标准.根据药敏试验及时开始针对病原菌的治疗很关键.结论 多重耐药草绿色链球菌引起的脑膜炎发病率虽低,也不可忽视,如合并菌血症可能与血行播散有关.获得明确病原学依据后推荐使用以万古霉素为基础的联用治疗方案.%Objective To investigate the anti-infective treatment of multidrug-resistant Streptococcus viridans meningitis complicated with bacteremia.Methods We explored the mechanisms of bacterial resistance and summarized the therapeutic regimen according to the participation of clinical pharmacists in an anti-infection treatment of multidrug-resistant Streptococcus viridans meningitis complicated with bacteremia.Results The timely results of cerebrospinal fluid culture and blood culture as well as the synthesis of cerebrospinal fluid smear,routine and biochemical tests are the key diagnostic criteria.It is vital to carry out the treatment targeting the pathogens timely via the drug sensitive tests.Conclusion Although the incidence of meningitis caused by multidrug-resistant Streptococcus viridans is not high,it can not be ignored.For example,the complicated bacteremia may be related to the hematogenous spread.It is recommended that the vancomycin based combination therapy be used on the clear etiological basis.