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病例分析

纹带棒状杆菌引发老年患者肺部感染1例并文献复习

  • 闵彦 ,
  • 李继霞
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  • 1. 中国人民解放军联勤保障部队第九六〇医院检验科,山东 济南 250031; 2. 中国人民解放军联勤保障部队第九六〇医院干部一科,山东 济南 250031

收稿日期: 2024-02-19

  网络出版日期: 2024-12-25

Pulmonary infection caused by Corynebacterium Striatum in an elderly patient: a case report and literature review

  • MIN Pan ,
  • LI Ji-Xia
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  • 1. Department of Laboratory Medicine, The 960th Hospital of the PLA, Jinan 250031, Shandong Province, China; 2. Department of Cadre Ward, The 960th Hospital of the PLA, Jinan 250031, Shandong Province, China

Received date: 2024-02-19

  Online published: 2024-12-25

摘要

本文对1例纹带棒状杆菌(Corynebacterium striatum)引发老年患者肺部感染的病例进行报道。患者男性,93岁,入院前2个月诊断为“吸入性肺炎”,给予哌拉西林他唑巴坦钠、亚胺培南西司他丁钠及左氧氟沙星进行治疗,但患者肺部感染难以控制,改用美洛培南进行抗感染治疗,效果欠佳。后经验性加用氟康唑抗真菌治疗,肺部感染仍迁延不愈,症状加重。痰培养报告提示,纹带棒状杆菌(++++),利奈唑胺对其的抑菌圈直径大。考虑上述治疗方案欠佳,停用氟康唑,调整为美洛培南联合利奈唑胺抗感染。此次调整抗菌药物10天后,患者咳嗽、咳痰症状逐步好转。后将美洛培南降阶为左氧氟沙星联合利奈唑胺抗感染,降阶治疗2天后,患者肺部感染好转,遂停用抗菌药物,肺部感染治疗成功。

本文引用格式

闵彦 , 李继霞 . 纹带棒状杆菌引发老年患者肺部感染1例并文献复习[J]. 微生物与感染, 2024 , 19(6) : 361 -366 . DOI: 10.3969/j.issn.1673-6184.2024.06.005

Abstract

This paper reports a case of pulmonary infection caused by Corynebacterium striatum in an elderly patient. The patient, male, 93 years old, was treated with piperacillin-tazobactam, imipenem-cilastatin and levofloxacin due to “aspiration pneumonia” two months ago. The patient’s pulmonary infection was difficult to control, and meropenem was upgraded for anti-infection, but the effect was not good. After empiric antifungal treatment with fluconazole, the pulmonary infection continued to persist and the symptoms worsened. Sputum culture result suggested Corynebacterium striatum (++++), and linezolid showed a large diameter inhibitory zone against the bacteria. Considering the previous treatment plan was not satisfactory, fluconazole was discontinued and the regimen was adjusted to meropenem combined with linezolid for anti-infection. Ten days after the adjustment of the antimicrobial agents, the patient’s symptoms of cough and sputum production gradually improved. Subsequently, meropenem was de-escalated to levofloxacin combined with linezolid for anti-infection. After 2 days of de-escalation therapy, the patient’s pulmonary infection improved, and the antimicrobial agents were discontinued, resulting in successful treatment of the pulmonary infection.
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