诺卡菌病10例  

Nocardiosis:a report of 10 cases

作　　者：林志强[1] 陈婷婷[1] 吴娜梅 LIN Zhiqiang;CHEN Tingting;WU Namei(Department of Pharmacy,Quanzhou First Hospital Affiliated to Fujian Medical University,Quanzhou Fujian 362000,China)

机构地区：[1]福建医科大学附属泉州第一医院药剂科,福建泉州362000

出　　处：《中国感染与化疗杂志》2021年第6期675-679,共5页Chinese Journal of Infection and Chemotherapy

摘　　要：目的探讨诺卡菌病的特点及诊治进展,为临床诊治提供帮助。方法收集福建医科大学附属泉州第一医院2015年1月-2020年12月确诊为诺卡菌病患者的临床资料进行回顾性分析。结果 10例诺卡菌病患者中,6例有基础疾病。感染部位有肺部感染和播散性感染各4例,单纯脑脓肿和皮肤感染各1例。所有病例均采用以甲氧苄啶-磺胺甲[口恶]唑为基础的治疗方案,除1例皮肤感染单用甲氧苄啶-磺胺甲[口恶]唑外,其他病例均采用联合治疗方案。亚胺培南和利奈唑胺是常用的联合治疗药物。10例患者中,7例病情好转,3例病情恶化。结论建议将甲氧苄啶-磺胺甲[口恶]唑作为诺卡菌感染的一线治疗方案。抗感染方案的制订应综合考虑诺卡菌的种类、药敏试验、感染部位、严重程度、患者免疫功能、药物相互作用、不良反应等。Objective To explore the characteristics of nocardiosis and latest advances in diagnosis and treatment for better clinical diagnosis and treatment.Methods A retrospective study was conducted to analyze the data of patients with nocardiosis admitted to Quanzhou First Hospital Affiliated to Fujian Medical University from January 2015 to December 2020.Results The 10 patients(8 males and 2 females)aged(52.6±39.6)years old.Six patients had complications.Overall,4 patients were diagnosed with pulmonary infection and 4 with disseminated infection,1 with brain abscess and 1 with skin infection.All patients were treated with a regimen containing trimethoprim-sulfamethoxazole(TMP-SMZ).Imipenem and linezolid are commonly used in combination therapy.The disease improved in 7 patients and worsened in 3 patients.Conclusions TMP-SMZ is recommended as the first-line treatment for Nocardia infection.Nocardia species,antimicrobial susceptibility,site of infection,disease severity,patient immune function,drug interactions,and adverse drug reactions should be considered when prescribing antimicrobial agents for nocardiosis.

关 键 词：诺卡菌 诺卡菌病 甲氧苄啶-磺胺甲[口恶]唑 亚胺培南 利奈唑胺 

分 类 号：R519.1[医药卫生—内科学]