A clinical study on the treatment of severe intracranial infection caused by carbapenem-resistant Gram-negative bacilli
Li Qinggang
Cheng Gang
Sun Junzhao
Zhang Jianning
Liu Ru'en
Li Xiaoyong
Abstract：Objective To investigate the drug resistance status,treatment methods,and prognosis of intracranial secondary carbapenem-resistant Gram-negative bacilli(CRGNB)infection after neurosurgical operations.Methods The clinical data of 54 patients confirmed cases of CRGNB infection were analyzed retrospectively.The intravenous administration of polymyxin,tigecycline,and intraventricular injection of polymyxin were combined with continuous cerebrospinal fluid drainage therapy.The clinical outcomes were summarized.Results Among the 54 patients with severe intracranial infections,44(81.48%)had intracranial infection complicated with hydrocephalus,accounting for the highest proportion.Acinetobacter baumannii infection was seen in 29 cases(53.70%),Klebsiella pneumoniae infection in 22(40.74%),Pseudomonas aeruginosa infection in 2(3.70%),and Enterobacter cloacae infection in 1 case(1.85%).After treatment,17 patients(31.48%)showed improvement,and 27(50.00%)achieved infection control,with an overall response rate of 81.48%.Acinetobacter baumannii and Klebsiella pneumoniae were the two infectious bacilli with the highest proportions,there was no statistically significant difference in infection outcomes between Acinetobacter baumannii and Klebsiella pneumoniae infections(P>0.05).Conclusions CRGNB infections are severe,with bacteria being multidrug-resistant,commonly represented by Acinetobacter baumannii and Klebsiella pneumoniae infections.Patients often experience complications,making treatment challenging.Therefore,intravenous and intraventricular combined medication should be selected as early as possible,and at the same time,effective cerebrospinal fluid drainage should be also performed to control bacterial infection as soon as possible,improving patient prognosis and enhancing survival rates.
Keywords：carbapenem resistanceGram-negative bacteriaintracranial infectionsevereoutcome
Publication Date：2024-02-20
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 75-80 )