Pharmaceutical care for a patient misdiagnosed as Staphylococcus intermedius pulmonary infection

Abstract

Abstract:

AIM: To provide reference for clinical rational use of drugs, clinical pharmacists carried out pharmaceutical care for a patient misdiagnosed as methicillin-resistant Staphylococcus intermedius pulmonary infection. METHODS: Pharmaceutical consultation and care on the patient with sputum culture and drug sensitivity test of methicillin-resistant Staphylococcus intermedius came into effects by analyzing and estimating the presence and degree of infection, the possible pathogens, the antimicrobial resistance, the empirical therapy, the goal-directed therapy, the monitoring of adverse drug reactions and the guidance to the patient. RESULTS: The results of multiple cultures suggested that the possible pathogen was multi-drug-resistant Acinetobacter baumannii. The symptoms and laboratory parameters of the patient were improved after dosage regimen of antimicrobial, and meanwhile no adverse drug reactions occurred. CONCLUSION: Clinical pharmacists participating in pharmaceutical care should not only have a solid knowledge of pharmaceutical knowledge professionally, but also should grasp the methods of relevant clinical diagnosis and the analysis abilities of laboratory testing results. This can provide better guidance to the clinical treatments.

Key words: clinical pharmacists, Staphylococcus intermedius, Acinetobacter baumannii, sputum culture

CLC Number:

LI Nan，HUANG Haitao，YONG Xiaolan. Pharmaceutical care for a patient misdiagnosed as Staphylococcus intermedius pulmonary infection[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2017, 22(9): 1067-1071.

References

［1］Galar A, Yuste JR, Espinosa M, et al. Clinical and economic impact of rapid reporting of bacterial identification and antimicrobial susceptibility results of the most frequently processed specimen types［J］. Eur J Clin Microbiol Infect Dis, 2012, 31(9): 2445-2452.
［2］Nguyen-Hieu T. Microbial sampling process can change results of microbiological analysis in periodontitis diagnosis. A minireview［J］. J Investig Clin Dent, 2013, 4(3): 151-159.
［3］Salluh JI, Soares M. ICU severity of illness scores: APACHE, SAPS and MPM［J］. Curr Opin Crit Care, 2014, 20(5): 557-565.
［4］Wang N, Neilan AM, Klompas M. Staphylococcus intermedius infections: case report and literature review［J］. Infect Dis Rep, 2013, 5(1): e3.
［5］Vandenesch F, Célard M, Arpin D, et al. Catheter-related bacteremia associated with coagulase-positive Staphylococcus intermedius［J］. J Clin Microbiol, 1995, 33(9): 2508-2510.
［6］Boerlin P, Eugster S, Gaschen F, et al. Transmission of opportunistic pathogens in a veterinary teaching hospital［J］. Vet Microbiol, 2001, 82(4): 347-359.
［7］陈佰义, 何礼贤, 胡必杰, 等. 中国鲍曼不动杆菌感染诊治与防控专家共识［J］. 中国医药科学, 2012, 2(8): 3-8.
［8］李小宁, 李娟, 姚永红. 鲍曼不动杆菌的耐药性及产ESBL和碳青霉烯酶分析［J］. 中国临床药理学与治疗学, 2012, 17(1): 30-33.
［9］胡付品, 朱德妹, 汪复, 等. 2013年中国CHINET细菌耐药性监测［J］. 中国感染与化疗杂志, 2014, 14(5): 369-378.
［10］喻华, 刘华, 黄文芳, 等. 四川省细菌耐药监测网2012年细菌耐药性监测［J］. 中国抗生素杂志, 2014, 39(5): 332-337.
［11］宋秀杰, 路聪哲, 方庭正，等. 老年支气管扩张合并急性感染的病原菌及其耐药性研究［J］. 中国临床药理学与治疗学, 2012, 17(8): 914-918.
［12］汪红, 胡龙华, 宁长秀，等. 耐碳青霉烯类抗生素鲍曼不动杆菌耐药机制的研究［J］. 中国临床药理学与治疗学, 2014, 17(12): 1093-1098.
［13］杨会志, 荚恒敏, 张莉莉. 2012年我院临床分离病原菌及耐药性监测分析［J］. 中国临床药理学与治疗学, 2012, 19(10): 1338-1342.
［14］Sato N, Suzuki H, Hayashi H, et al. New concept and a theoretical consideration of the mechanism-based pharmacokinetics/ pharmacodynamics (PK/PD) modeling for antimicrobial agents［J］. Jpn J Antibiot, 2008, 61(5): 314-338.
［15］叶有娣, 谢家政. 多重耐药鲍曼不动杆菌治疗药物研究进展［J］. 中国临床药理学与治疗学, 2016, 21(1): 116-120.
［16］Fishbain J, Peleg AY. Treatment of Acinetobacter infections［J］. Clin Infect Dis, 2010, 51(1): 79-84．
［17］Garnacho-Montero J, Amaya-Villar R. Multiresistant Acinetobacter baurnannii infections：epidemiology and management［J］. Curr Opin Infect Dis, 2010, 23(4): 332-339．

[1]	ZHANG Zhaowei, LI Zuojun, HUANG Jian, LI Shuangqing, HE YiLin. Exploring the outbreak point for clinical pharmacists to provide pharmaceutical care in nephrology department [J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2023, 28(2): 184-188.
[2]	FU Peishu, SUN Fengjun, FENG Wei, XIONG Lirong, LI Xiaoyu, XIA Peiyuan. Progress in drug therapy for multidrug-resistant Acinetobacter baumannii infection [J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2019, 24(10): 1181-1187.
[3]	YU Yang, HE Jiake, XIONG Aizhen, DING Nan. Role of clinical pharmacists in the anti-infective therapy after anterior cruciate ligament reconstructions: an individualized medicine perspective [J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2017, 22(2): 194-197.
[4]	WANG Yu, HU Xiao-lei, TANG Min. Pharmaceutical care for clinical therapy in a patient with bacteremia [J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2014, 19(4): 415-418.
[5]	WANG Hong, HU Long-hua, NING Chang-xiu, HANG Ya-ping, ZHONG Qiao-shi, HU Xiao-yan, ZHANG Bai-ling, JIA Kun-ru. Study on the mechanism of carbapenem resistance in Acinetobacter baumannii [J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2014, 19(10): 1093-1098.
[6]	HE Xian-di, YAN Pei-e, ZHOU Qi, WANG Hua-xue. Effects of Xuebijing for injection on neutrophil TCTP expression in Acinetobacter baumannii sepsis rats [J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2014, 19(1): 29-32.
[7]	LI Xiao-ning, LI Juan, YAO Yong-hong. Analysis on resistance of Acinetobacter Baumannii and the extended spectrum beta-lactamases and carbapenemases [J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2012, 17(1): 30-33.
[8]	LI Ran, SHI Lu-wen, WANG Rui, LIANG Bei-bei, SONG Xiu-jie, CAI Yun. Study on in vitro antimicrobial activity of Colistin and other antibiotics against Acinetobacter baumannii [J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2009, 14(3): 287-291.