Sucu Nurgün, Köksal Iftihar, Yilmaz Gürdal, Aydin Kemalettin, Caylan Rahmet, Aktoz Boz Gönülden
Karadeniz Teknik Universitesi Tip Fakültesi, Infeksiyon Hastaliklan ve Klinik Mikrobiyoloji Anabilim Dali, Trabzon.
Mikrobiyol Bul. 2006 Oct;40(4):389-95.
The genus Ruminococcus which are anaerobe Gram positive cocci, previously classified as Peptostreptococcus, may colonize the upper respiratory tract, gastrointestinal tract, vagina and skin of humans and animals. In this report a case of liver abscess and a case of infective endocarditis caused by Ruminoccocus productus, which is very rarely encountered in the clinical practice were presented. The first case was a 32 years old male who was admitted to the hospital in 2002, with the complaints of fever lasting for 20 days and pain while breathing. The abdominal ultrasonography revealed the presence of a liver abscess, and the drainage material from the abscess yielded Ruminococcus productus, identified in BACTEC 9200 (Becton Dickinson, Sparks, Md) anaerobe system. As the isolate was found to be sensitive to penicilin, the empirical gentamicin and ampicillin/sulbactam therapy was continued. The second case was a 25 years old male who was admitted to the hospital in 2005, with the signs of fever lasting for 3-4 months, chills, bone and joint pains. As multiple vegetations were detected in echocardiography, blood cultures were collected and empirical therapy with ceftriaxone and gentamicin was initiated with the preliminary diagnosis of infective endocarditis. Bacteria which were isolated from blood cultures by BACTEC 9200 system have been identified as R. productus. As this strain was also sensitive to penicillin, the empirical therapy was changed to penicilin and gentamicin. These two cases indicated that R. productus should be considered in complicated infections even if it is a rarely isolated species from the clinical samples.
瘤胃球菌属是厌氧革兰氏阳性球菌，以前被归类为消化链球菌属，可定殖于人和动物的上呼吸道、胃肠道、阴道及皮肤。本报告介绍了两例临床实践中极为罕见的由产瘤胃球菌引起的肝脓肿和感染性心内膜炎病例。第一例是一名32岁男性，于2002年入院，主诉发热持续20天及呼吸时疼痛。腹部超声检查发现有肝脓肿，脓肿引流物中产瘤胃球菌在BACTEC 9200（美国马里兰州斯帕克斯市百特公司）厌氧系统中得以鉴定。由于分离株对青霉素敏感，故继续经验性使用庆大霉素和氨苄西林/舒巴坦治疗。第二例是一名25岁男性，于2005年入院，有持续3至4个月的发热、寒战、骨关节疼痛症状。因超声心动图检测到多个赘生物，采集血培养标本并初步诊断为感染性心内膜炎后开始经验性使用头孢曲松和庆大霉素治疗。通过BACTEC 9200系统从血培养中分离出的细菌被鉴定为产瘤胃球菌。由于该菌株对青霉素也敏感，故将经验性治疗改为青霉素和庆大霉素。这两例病例表明，即使产瘤胃球菌是临床样本中很少分离出的菌种，在复杂感染中也应考虑到该菌。
