1例戊糖片球菌所致颈部多间隙感染伴胸壁脓肿患者抗感染治疗的药学监护  

Pharmaceutical Care for Anti-infection Treatment in One Patient with Neck Multi-space Infection and ChestWall Abscess Induced by Pediococcus Pentosaceus

作　　者：龙江美 刘蕾[2] 倪茂美[2] 叶惠平 钱鑫[2] LONG Jiang-mei;LIU Lei;NI Mao-mei;YE Hui-ping;QIAN Xin(Qingzhen Hongta Community Health Service Center,Qingzhen Guizhou 551400,China;Guizhou Provincial People's Hospital,Guiyang 550002,China)

机构地区：[1]清镇市红塔社区卫生服务中心,贵州清镇551400 [2]贵州省人民医院,贵阳550002

出　　处：《抗感染药学》2024年第7期677-681,共5页Anti-infection Pharmacy

摘　　要：目的:分析戊糖片球菌所致颈部多间隙感染伴胸壁脓肿患者抗感染治疗的药学监护过程,为临床戊糖片球菌感染患者的诊断和治疗提供参考。方法与结果:某患者因“咽部疼痛6 d,伴咳痰、发热、吞咽困难、张口受限”,至医院急诊就诊,医生检查后考虑为颈部多间隙感染伴胸壁脓肿,随后收入耳鼻喉科;入院第1天,行脓肿切开引流术并置引流管排脓,取脓液行微生物培养,同时经验性予头孢哌酮-舒巴坦钠+奥硝唑;第5天,脓液中培养出戊糖片球菌,临床药师查阅资料后建议将抗感染治疗方案调整为氨苄西林;第8天,患者左侧胸壁仍有肿胀,遂行二次手术,并置引流管排脓;随后的3周内,患者脓肿逐渐消失,创面逐渐恢复,且未见渗血及红肿,基本治愈。结论:戊糖片球菌感染在临床上较为少见,加之存在较严重的脓肿形成,医生和药师应充分重视,并综合运用内外科手段,以保证治疗的效果。Objective:To analyze the pharmaceutical care process of anti-infection treatment in patients with neck multi-space infection and chest wall abscess induced by Pediococcus pentosaceus,and provide a reference for the diagnosis and treatment of patients with Pediococcus pentosaceus infection in clinical practice.Methods and Results:A patient went to the hospital's emergency department due to"sore throat for 6 days,accompanied by expectoration,fever,dysphagia,and restriction of mouth opening".After examination,the doctor considered it to be neck multi-space infection with chest wall abscess,then the patient was admitted to the otolaryngology department;on the first day of admission,abscess incision and drainage was performed and a drainage tube was placed to drain the pus.The pus was used for microbial culture,and cefoperazone-sulbactam sodium+ornidazole were given empirically.On the fifth day,Pediococcus pentosaceus was cultured in the pus.After referring to related data,the clinical pharmacist suggested adjusting the anti-infection treatment regimen to ampicillin;on the eighth day,the patient's left chest wall was still swollen,so a second operation was performed and a drainage tube was placed to drain the pus;in the following 3 weeks,the patient's abscess gradually disappeared,the wound surface gradually recovered,and no bleeding,redness and swelling were observed,and the patient was basically cured.Conclusion:The infection with Pediococcus pentosaceus is relatively rare in clinical practice;in addition,a serious abscess was formed for the patient.Therefore,doctors and pharmacists should attach importance to it and take internal medicine and surgical methods to ensure the treatment effect.

关 键 词：戊糖片球菌 颈部多间隙感染 胸壁脓肿 抗感染治疗 药学监护 

分 类 号：R97[医药卫生—药品] R378.1[医药卫生—药学]