Daxboeck Florian, Zitta Sabine, Assadian Ojan, Krause Robert, Wenisch Christoph, Kovarik Josef
Institute of Hygiene, Division of Hospital Hygiene, and Department of Internal Medicine III, University Hospital Vienna, Vienna, Austria.
Am J Kidney Dis. 2002 Oct;40(4):E17. doi: 10.1053/ajkd.2002.35759.
We report two cases of bacteremia with Ochrobactrum anthropi in patients on hemodialysis. Bacteremia became clinically manifest by recurrent febrile episodes during and after dialysis. In one patient, bacteremia persisted after ciprofloxacin therapy and was cleared only by removal of the dialysis catheter and a 3-week course of gentamicin. The second patient remained intermittently bacteremic for more than 3 months, although the dialysis catheter had been replaced. A MEDLINE search revealed only one previous report of O anthropi bloodstream infection in a patient on hemodialysis, but the pathogen is recognized increasingly as a causative agent of human disease, most importantly in debilitated patients. In contrast to most previously described cases, the two patients reported here had no malignancies and were not on immunosuppressive therapy. Treatment of O anthropi infection is challenging because of widespread and unpredictable resistance to antimicrobial agents and discrepancies between in vitro susceptibility and in vivo efficacy.
我们报告了两例接受血液透析患者发生嗜水气单胞菌菌血症的病例。菌血症在透析期间及之后表现为反复发热发作。在一名患者中，环丙沙星治疗后菌血症仍持续存在，仅通过拔除透析导管和为期3周的庆大霉素疗程才得以清除。第二名患者尽管更换了透析导管，但菌血症间歇性持续了3个多月。医学文献数据库检索仅发现此前有一篇关于血液透析患者发生嗜水气单胞菌血流感染的报告，但该病原体越来越被认为是人类疾病的病原体，在虚弱患者中尤为重要。与大多数先前描述的病例不同，这里报告的两名患者没有恶性肿瘤，也未接受免疫抑制治疗。由于对抗菌药物广泛且不可预测的耐药性以及体外药敏与体内疗效之间的差异，嗜水气单胞菌感染的治疗具有挑战性。
