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題 名 | Adult Citrobacter Freundii Meningitis: Case Report=成人檸檬酸桿菌腦膜炎:病例報告 |
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作 者 | 莊曜聰; 張文能; 盧成憲; | 書刊名 | 長庚醫學 |
卷 期 | 22:4 1999.12[民88.12] |
頁 次 | 頁649-653 |
分類號 | 415.9313 |
關鍵詞 | 檸檬酸桿菌; 腦膜炎; 多重抗藥性; 硬腦膜下膿瘍; Citrobacter freundii; Meningitis; Multiple resistance; Subdural empyema; |
語 文 | 英文(English) |
中文摘要 | 檸檬酸桿茵屬(Citrobacter)是一群屬於腸細茵科且具特徵的革蘭氏陰性稈菌。其 所引起的中樞神經系統感染較不尋常且多發生於新生兒及幼童。成人檸檬酸桿菌腦膜炎極為 少見,至1998年止文獻上僅有6病例報告。此種感染易發生在頭部外傷、神經外科手術後和 免疫機能低下之病人。在6報告病例之中,僅有一例為多重抗藥性之檸檬酸桿菌中樞神經系 統感染。本文報告一名成人因神經外科手術後而感染多重抗藥性之Citrobacter freundii 腦膜炎及硬腦膜下膿瘍,並且做文獻回顧。在此病例中,使用imipenem和第三代頭芽胞菌素 (cephalosporins)治療無法在腦脊髓液內達到滅菌之效果。由於廣效性抗生素之使用,多重 抗藥性之檸檬酸桿菌已經在此種院內中樞神經系統感染症中出現,且引起治療上的挑戰。因 此,進一步臨床研究以決定先進的治療此一危及生命的感染症之方式是必須的。 |
英文摘要 | Citrobacter is a distinct group of Gram-negative bacilli belonging to the Enterobacteriaceae family. Central nervous system (CNS) infections due to Citrobacter are uncommon, though they occur more frequently in neonates and young children. In adults, Citrobacter meningitis is extremely unusual with only 6 cases reported in the literature before 1998. This rare CNS infection has been seen in patients with head trauma, following neurosurgical procedures, and in those who are immunocompromised. Of the patients in the 6 reported cases, only one developed multi-antibiotic resistant Citrobacter CNS infection. Adding to this small number of reported cases, we report an adult case of post-neurosurgical meningitis and subdural empyema caused by multi-antibiotic resistant Citrobacter freundii and also review the literature related to this infection. Antimicrobial therapy with imipenem and third-generation cephalosporins failed to result in cerebrospinal fluid sterilization in our patient. Because of the use of broad-spectrum antibiotics, multi-antibiotic resistant Citrobacter species have developed in this nosocomial CNS infection and now present a therapeutic challenge. Therefore, further clinical studies are needed to determine updated therapeutic modalities for treating this life-threatening infection. |
本系統中英文摘要資訊取自各篇刊載內容。