临床药师参与颅脑术后肺部继发按蚊伊丽莎白金菌等多种细菌感染治疗1例  

Participation of clinical pharmacists in the treatment of multiple bacterial infections,including Elizabethkingella anophelis,in the lungs secondary to craniofacial surgery in one case

作　　者：廖荣强 刘颖 LIAO Rongqiang;LIU Ying(Department of Pharmacy,Chongqing Emergency Medical Center,Chongqing400014,China)

机构地区：[1]重庆市急救医疗中心药剂科,重庆400014

出　　处：《中国医药导报》2024年第33期190-193,共4页China Medical Herald

基　　金：重庆市临床药学重点专科建设项目(渝卫办发〔2023〕69号)。

摘　　要：在神经外科重症监护环境中,医院获得性感染尤其是多重耐药菌感染的管理是提升患者预后的重要挑战。本文报告1例颅脑术后患者的复杂肺部感染的治疗经过。该患者经历了从术后常规抗感染治疗到几种多重耐药菌相继感染的过程,特别是按蚊伊丽莎白金菌不常见病原体的管理。面对复杂的感染情况,临床医师与临床药师紧密合作,依据细菌培养及药敏试验结果,动态调整抗感染治疗方案。患者最终成功脱离呼吸机并顺利出院继续康复治疗。本案例强调了神经外科重症患者医院获得性感染管理的复杂性。同时,也提醒临床工作者在面对多重耐药菌感染时,需及时、准确地调整治疗方案,以优化患者预后,避免不良后果。In the neurosurgical intensive care unit,managing hospital-acquired infections,especially those involving multidrug-resistant bacteria,challenges patient outcomes.This paper reports the treatment of the complex pulmonary infection in one craniotomy patient.This patient experienced a progression from routine postoperative anti-infective therapy to successive infections with several multidrug-resistant organisms,particularly with the management of the uncommon pathogen Elizabethkingia anophelis.In the face of complex infections,clinicians work closely with clinical pharmacists to dynamically adjust anti-infective treatment regimens based on bacterial culture and drug sensitivity test results.The patient was eventually successfully taken off the ventilator and discharged to continue rehabilitation.This case highlights the complexity of managing hospital-acquired infections in neurosurgical intensive care patients.It also reminds clinical workers of the need to promptly and accurately adjust treatment regimens in the face of multidrug-resistant bacterial infections in order to optimize patient prognosis and avoid adverse outcomes.

关 键 词：多重耐药 按蚊伊丽莎白金菌 呼吸机相关肺炎 临床药师 

分 类 号：R563.1[医药卫生—呼吸系统]