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首页> 外文期刊>Infectious Diseases and Therapy >Treatment of Methicillin-Resistant Staphylococcus aureus (MRSA) Pneumonia with Ceftaroline Fosamil in a Patient with Inhalational Thermal Injury
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Treatment of Methicillin-Resistant Staphylococcus aureus (MRSA) Pneumonia with Ceftaroline Fosamil in a Patient with Inhalational Thermal Injury

机译：头孢洛林福沙米尔治疗吸入性热损伤患者的耐甲氧西林金黄色葡萄球菌（MRSA）肺炎

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A 48-year-old female, who was found unresponsive and suffered inhalation injury secondary to a house fire, was transferred to our burn center for definitive treatment. Post tracheostomy, the patient became febrile and tachycardic. On hospital day (HD) 5, the patient expressed thick yellow secretions during suctioning and diffuse rhonchi was noted on physical exam. Blood cultures and a culture from the broncheo-alvelolar lavage grew Gram-positive cocci in clusters and the patient was started on empiric vancomycin. Despite aggressive vancomycin dosing (1750?mg intravenously every 6?h), the patient’s status continued to deteriorate. The organism was identified as methicillin-resistant Staphylococcus aureus (MRSA) with a vancomycin minimum inhibitory concentration (MIC) of 2?mg/L. Based on the potential for drug–drug interactions with linezolid, the patient was started on ceftaroline fosamil (MIC?=?0.5?mg/L) 600?mg intravenously every 8?h with a prolonged 2-h infusion to anticipate suboptimal concentrations secondary to thermal burn injury. Post change in antibiotic therapy, a rapid clinical improvement was observed with the patient becoming afebrile at 48?h after initiation of ceftaroline. The patient completed a total of 14?days of ceftaroline therapy and was subsequently weaned from the ventilator on HD 22 and decannulated 2?days later. To our knowledge, this is the first report of the use of ceftaroline for the treatment of MRSA pneumonia in a patient with thermal injury.
机译：一名48岁的女性被发现无反应，并在房屋大火后遭受吸入伤害，被转移到我们的烧伤中心接受彻底治疗。气管切开术后，患者发热并心动过速。在医院第5天（HD），患者在抽吸过程中表达出浓密的黄色分泌物，体格检查发现弥漫性罗氏菌。血液培养和来自支气管肺泡灌洗的培养物簇生革兰氏阳性球菌，患者开始接受经验性万古霉素治疗。尽管使用了万古霉素的剂量很高（每6？h静脉注射1750 mg），但患者的状况持续恶化。该生物被鉴定为耐甲氧西林的金黄色葡萄球菌（MRSA），万古霉素的最低抑菌浓度（MIC）为2？mg / L。根据与利奈唑胺可能发生的药物相互作用，患者每8？h静脉注射头孢洛林fosamil（MIC？=？0.5？mg / L）600？mg，开始2 h延长输注，以预料次优浓度热灼伤。抗生素治疗改变后，观察到迅速的临床改善，患者在头孢洛林起始后48h开始发热。该患者完成了总共14天的头孢洛林治疗，随后在HD 22上从呼吸机断奶，并在2天后拔除鼻烟。据我们所知，这是头孢洛林在热损伤患者中治疗MRSA肺炎的首次报道。

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