莫西沙星治疗超早产儿人型支原体脑膜炎1例

毛玮莹, 蓝江儿, 甘明宇, 张迅捷, 俞蕙, 胡黎园, 张蓉, 曹云, 肖蜜黎

中国当代儿科杂志 ›› 2024, Vol. 26 ›› Issue (4) : 432-436.

PDF(572 KB)
PDF(572 KB)
中国当代儿科杂志 ›› 2024, Vol. 26 ›› Issue (4) : 432-436. DOI: 10.7499/j.issn.1008-8830.2312016
多学科诊疗专栏

莫西沙星治疗超早产儿人型支原体脑膜炎1例

  • 毛玮莹1, 蓝江儿2, 甘明宇3, 张迅捷2, 俞蕙4, 胡黎园1, 张蓉1, 曹云1, 肖蜜黎1
作者信息 +

Moxifloxacin treatment for Mycoplasma hominis meningitis in an extremely preterm infant

  • MAO Wei-Ying, LAN Jiang-Er, GAN Ming-Yu, ZHANG Xun-Jie, YU Hui, HU Li-Yuan, ZHANG Rong, CAO Yun, XIAO Mi-Li
Author information +
文章历史 +

摘要

患儿男,生后2 h,因早产(胎龄27+5周)、生后气促2 h入院。患儿入院后出现发热,血C反应蛋白升高,生后第4天脑脊液宏基因组二代测序示人型支原体阳性(序列数9 898);生后第8天复查脑脊液宏基因组二代测序示人型支原体阳性(序列数56 806)阳性。患儿人型支原体化脓性脑膜炎诊断明确,抗生素调整为莫西沙星静脉滴注[5 mg/(kg·d)],总疗程4周。治疗后患儿脑脊液检查恢复正常,于生后第76天治愈出院。该文对新生儿人型支原体化脓性脑膜炎的诊断和治疗进行重点描述,介绍超早产儿人型支原体化脓性脑膜炎的多学科诊疗。

Abstract

The patient, a male newborn, was admitted to the hospital 2 hours after birth due to prematurity (gestational age 27+5 weeks) and respiratory distress occurring 2 hours postnatally. After admission, the infant developed fever and elevated C-reactive protein levels. On the fourth day after birth, metagenomic next-generation sequencing of cerebrospinal fluid indicated a positive result for Mycoplasma hominis (9 898 reads). On the eighth day, a retest of cerebrospinal fluid metagenomics confirmed Mycoplasma hominis (56 806 reads). The diagnosis of purulent meningitis caused by Mycoplasma hominis was established, and the antibiotic treatment was switched to moxifloxacin [5 mg/(kg·day)] administered intravenously for a total of 4 weeks. After treatment, the patient's cerebrospinal fluid tests returned to normal, and he was discharged as cured on the 76th day after birth. This article focuses on the diagnosis and treatment of neonatal Mycoplasma hominis purulent meningitis, introducing the multidisciplinary diagnosis and treatment of the condition in extremely preterm infants.

关键词

化脓性脑膜炎 / 人型支原体 / 莫西沙星 / 超早产儿

Key words

Purulent meningitis / Mycoplasma hominis / Moxifloxacin / Extremely preterm infant

引用本文

导出引用
毛玮莹, 蓝江儿, 甘明宇, 张迅捷, 俞蕙, 胡黎园, 张蓉, 曹云, 肖蜜黎. 莫西沙星治疗超早产儿人型支原体脑膜炎1例[J]. 中国当代儿科杂志. 2024, 26(4): 432-436 https://doi.org/10.7499/j.issn.1008-8830.2312016
MAO Wei-Ying, LAN Jiang-Er, GAN Ming-Yu, ZHANG Xun-Jie, YU Hui, HU Li-Yuan, ZHANG Rong, CAO Yun, XIAO Mi-Li. Moxifloxacin treatment for Mycoplasma hominis meningitis in an extremely preterm infant[J]. Chinese Journal of Contemporary Pediatrics. 2024, 26(4): 432-436 https://doi.org/10.7499/j.issn.1008-8830.2312016

参考文献

1 Ahmed J, Rawre J, Dhawan N, et al. Mycoplasma hominis: an under recognized pathogen[J]. Indian J Med Microbiol, 2021, 39(1): 88-97. PMID: 33610259. DOI: 10.1016/j.ijmmb.2020.10.020.
2 Waites KB, Katz B, Schelonka RL. Mycoplasmas and ureaplasmas as neonatal pathogens[J]. Clin Microbiol Rev, 2005, 18(4): 757-789. PMID: 16223956. PMCID: PMC1265909. DOI: 10.1128/CMR.18.4.757-789.2005.
3 Waites KB, Duffy LB, Crouse DT, et al. Mycoplasmal infections of cerebrospinal fluid in newborn infants from a community hospital population[J]. Pediatr Infect Dis J, 1990, 9(4): 241-245. PMID: 2336309. DOI: 10.1097/00006454-199004000-00004.
4 Waites KB, Rudd PT, Crouse DT, et al. Chronic Ureaplasma urealyticum and Mycoplasma hominis infections of central nervous system in preterm infants[J]. Lancet, 1988, 1(8575/6): 17-21. PMID: 2891889. DOI: 10.1016/s0140-6736(88)91002-1.
5 Krausse R, Schubert S. In-vitro activities of tetracyclines, macrolides, fluoroquinolones and clindamycin against Mycoplasma hominis and Ureaplasma ssp. isolated in Germany over 20 years[J]. Clin Microbiol Infect, 2010, 16(11): 1649-1655. PMID: 20047607. DOI: 10.1111/j.1469-0691.2009.03155.x.
6 Ahmadi MH. Resistance to tetracyclines among clinical isolates of Mycoplasma hominis and Ureaplasma species: a systematic review and meta-analysis[J]. J Antimicrob Chemother, 2021, 76(4): 865-875. PMID: 33367765. DOI: 10.1093/jac/dkaa538.
7 Wildenbeest JG, Said I, Jaeger B, et al. Neonate with Mycoplasma hominis meningoencephalitis given moxifloxacin[J]. Lancet Infect Dis, 2016, 16(11): e261-e266. PMID: 27641775. DOI: 10.1016/S1473-3099(16)30162-1.
8 Watt KM, Massaro MM, Smith B, et al. Pharmacokinetics of moxifloxacin in an infant with Mycoplasma hominis meningitis[J]. Pediatr Infect Dis J, 2012, 31(2): 197-199. PMID: 22016080. PMCID: PMC3358780. DOI: 10.1097/INF.0b013e31823980c3.
9 Ansari NS, Asztalos E, Rolnitsky A. Mycoplasma hominis meningitis in an extremely preterm newborn: a case report[J]. BMC Pediatr, 2021, 21(1): 69. PMID: 33557784. PMCID: PMC7869195. DOI: 10.1186/s12887-021-02532-3.
10 Nohren J, Namtu K, Peloquin C, et al. The pharmacokinetics of moxifloxacin in cerebrospinal fluid following intravenous administration: a report of successfully treated infant with Mycoplasma hominis meningitis[J]. Pediatr Infect Dis J, 2020, 39(8): e183-e184. PMID: 32195773. DOI: 10.1097/INF.0000000000002655.
11 Yeung T, Chung E, Chen J, et al. Therapeutic drug monitoring of moxifloxacin to guide treatment of Mycoplasma hominis meningitis in an extremely preterm infant[J]. J Pediatr Pharmacol Ther, 2021, 26(8): 857-862. PMID: 34790077. PMCID: PMC8592008. DOI: 10.5863/1551-6776-26.8.857.
12 McDonald JC, Moore DL. Mycoplasma hominis meningitis in a premature infant[J]. Pediatr Infect Dis J, 1988, 7(11): 795-798. PMID: 3231501. DOI: 10.1097/00006454-198811000-00011.
13 Watson L, Pang YM, Mitchell S, et al. Mycoplasma hominis meningitis in a 24 week premature neonate: case report and short literature review[J]. J Pediatr Pharmacol Ther, 2008, 13(4): 251-254. PMID: 23055884. PMCID: PMC3461990. DOI: 10.5863/1551-6776-13.4.251.
14 Kersin SG, Bozan T, ?zdemir H, et al. Clinical and laboratory awareness for an under recognized pathogen in newborn meningitis: Mycoplasma hominis: a case report[J]. Turk J Pediatr, 2020, 62(2): 280-283. PMID: 32419421. DOI: 10.24953/turkjped.2020.02.015.
15 胡莹莹, 陈滨温, 陈尚勤, 等. 超早产儿人型支原体脑膜炎1例并文献复习[J]. 中华围产医学杂志, 2022, 25(4): 284-289. DOI: 10.3760/cma.j.cn113903-20210825-00734.
16 中华医学会儿科学分会新生儿学组, 中华儿科杂志编辑委员会. 宏基因组二代测序技术在新生儿感染性疾病中的临床应用专家共识[J]. 中华儿科杂志, 2022, 60(6): 516-521. PMID: 35658355. DOI: 10.3760/cma.j.cn112140-20220113-00046.
17 Hata A, Honda Y, Asada K, et al. Mycoplasma hominis meningitis in a neonate: case report and review[J]. J Infect, 2008, 57(4): 338-343. PMID: 18790539. DOI: 10.1016/j.jinf.2008.08.002.

PDF(572 KB)

Accesses

Citation

Detail

段落导航
相关文章

/