Harada Noboru, Soejima Yuji, Taketomi Akinobu, Yoshizumi Tomoharu, Uchiyama Hideaki, Maehara Yoshihiko
Department of Surgery and Medical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Surg Today. 2008;38(5):469-72. doi: 10.1007/s00595-007-3622-5. Epub 2008 Apr 30.
Stenotrophomonas maltophilia (previously named Xanthomonas maltophilia) is an aerobic, nonfermentive, Gram-negative bacillus that is widespread in the environment. It is considered to be an organism with a limited pathogenic potential, which is rarely capable of causing diseases in humans other than in those who are in an immunocompromised state. In this study, we outline the case of a patient with Stenotrophomonas maltophilia bacteremia after living donor liver transplantation, which showed the clinical signs of severe sepsis and was resistant to almost all antibiotics. However, we successfully treated the patient with the antibiotics trimethoprim-sulfamethoxazole (TMP/SMX) and minocycline hydrochloride (MINO), and performed endotoxin-absorbing therapy using polymyxin B (PMX) to remove the endotoxin from Gram-negative bacillus as well as continuous hemodiafiltration (CHDF) to remove inflammatory cytokines. To the best of our knowledge, this is the first report on the treatment of Stenotrophomonas maltophilia bacteremia after living donor liver transplantation.
嗜麦芽窄食单胞菌(以前称为嗜麦芽黄单胞菌)是一种需氧、非发酵、革兰氏阴性杆菌,广泛存在于环境中。它被认为是一种致病潜力有限的微生物,除了免疫功能低下的人外,很少能在人类中引起疾病。在本研究中,我们概述了一例活体供肝移植后发生嗜麦芽窄食单胞菌血症的患者病例,该患者表现出严重脓毒症的临床症状,并且对几乎所有抗生素耐药。然而,我们使用抗生素甲氧苄啶-磺胺甲恶唑(TMP/SMX)和盐酸米诺环素(MINO)成功治疗了该患者,并使用多粘菌素B(PMX)进行内毒素吸附治疗以清除革兰氏阴性杆菌产生的内毒素,以及进行连续性血液透析滤过(CHDF)以清除炎性细胞因子。据我们所知,这是关于活体供肝移植后嗜麦芽窄食单胞菌血症治疗的首次报告。