1개 병원에서 경험한 다제 내성 Acinetobacter baumannii 중추신경계 감염 3예

Three Cases of Central Nervous System Infection Caused by Multi-Drug-Resistant Acinetobacter baumannii

  • 김은영 (경희대학교 의학전문대학원 내과학교실) ;
  • 문송미 (경희대학교 의학전문대학원 내과학교실) ;
  • 김연주 (경희대학교 의학전문대학원 내과학교실) ;
  • 박현진 (경희대학교 의학전문대학원 내과학교실) ;
  • 손준성 (경희대학교 의학전문대학원 내과학교실) ;
  • 이미숙 (경희대학교 의학전문대학원 내과학교실)
  • Kim, Eun-Yeong (Department of Internal Medicine, Kyung Hee University School of Medicine) ;
  • Moon, Song-Mi (Department of Internal Medicine, Kyung Hee University School of Medicine) ;
  • Kim, Yeon-Ju (Department of Internal Medicine, Kyung Hee University School of Medicine) ;
  • Park, Hyun-Jin (Department of Internal Medicine, Kyung Hee University School of Medicine) ;
  • Son, Jun-Seong (Department of Internal Medicine, Kyung Hee University School of Medicine) ;
  • Lee, Mi-Suk (Department of Internal Medicine, Kyung Hee University School of Medicine)
  • 발행 : 2011.01.01

초록

최근 병원획득성 중추신경계 감염의 원인균으로 드물지만 심각한 임상경과를 보이므로 A. baumannii가 주목받고 있으며, 또한 다제내성 A. baumannii가 나타남에 따라 치료의 어려움이 증가하고 있다. 하지만 국내에서 중추신경계 다제내성 A. baumannii 감염에 대한 보고 및 연구를 찾기 힘든 실정이다. 이에 저자들은 중추신경계 다제내성 A. baumannii 감염 3예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

In recent years, Acinetobacter baumannii has become an increasingly common nosocomial pathogen. It causes rare, but severe, central nervous system (CNS) infection, especially in patients undergoing neurosurgical procedures or with head trauma. Multi-drug-resistant A. baumannii (MDR-AB) has emerged as a pathogen causing CNS infection. We describe A. baumannii CNS infections seen during the last 5 years and focus on MDR-AB CNS infection. Seven patients were admitted to the neurosurgical intensive care unit with serious head injuries. Imipenem-susceptible A. baumannii was identified in all four cases seen from 2003 to 2006, whereas the three cases seen from 2007 to 2008 were MDR-AB CNS infections. Two cases of MDR-AB CNS infection were cured with intraventricular or intrathecal colistin without any side effects. Therefore, intraventricular or intrathecal colistin should be considered for MDR-AB CNS infection. Studies of the dose and duration of intraventricular and intrathecal administration are needed.

키워드

참고문헌

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