Bulut Cemal, Yetkin M Arzu, Koruk Süda Tekin, Erdinç F Sebnem, Karakoç Esra Alp
SB Ankara Eğitim ve Araştirma Hastanesi, Enfeksiyon Hastaliklari ve Klinik Mikrobiyoloji Kliniği, Ankara.
Mikrobiyol Bul. 2008 Oct;42(4):685-8.
Sphingomonas paucimobilis, is a yellow-pigmented, aerobic, non-fermentative, non-spore-forming, gram-negative bacillus. Infections by S. paucimobilis which is widely found in nature and hospital environments are rarely serious or life threatening. In this report we present a case of hospital acquired bloodstream infection due to S. paucimobilis. The patient had a history of hydrocephalus diagnosed at sixth months of his birth and had experienced two ventriculoperitoneal shunt surgery. He was hospitalized and been treated for bronchopneumonia. On the 47th day of hospitalization, blood cultures (BACTEC, Becton Dickinson, USA) were taken because of a body temperature of 38.5 degrees C. One of the blood cultures was positive for gram-negative rods. After 48 h of incubation, the sub-cultures on blood agar medium yielded pure growth of a yellow, non-fermentative, gram-negative, rod-shaped bacterium. The microorganism was positive for oxidase, and esculin hydrolysis, while negative for urea and nitrate reduction and citrate utilisation. Motility was negative as well. The isolate has been identified as S. paucimobilis by using mini API (bioMerieux, France) system. The antibiotic susceptibility test was also performed with the same system and the strain was found susceptible to ceftazidime, ceftriaxone, cefoperazone, cefepime, cefotaxime, ciprofloxacin, imipenem, piperacillin-tazobactam, aztreonam, amikasin and gentamicin. Treatment with intravenous ceftriaxone (2 x 750 mg/day) was initiated. He responded well to the treatment and discharged on the tenth day. This case was reported to emphasize that S. paucimobilis should be kept in mind as a nosocomial infectious agent and the infections should be treated according to the sensitivity test results.
少动鞘氨醇单胞菌是一种产黄色色素、需氧、不发酵、不形成芽孢的革兰氏阴性杆菌。少动鞘氨醇单胞菌广泛存在于自然环境和医院环境中,由其引起的感染很少严重或危及生命。在本报告中,我们呈现了一例因少动鞘氨醇单胞菌导致的医院获得性血流感染病例。该患者在出生六个月时被诊断为脑积水,曾接受过两次脑室腹腔分流手术。他因支气管肺炎住院治疗。住院第47天,因体温达到38.5摄氏度进行了血培养(美国BD公司的BACTEC系统)。其中一份血培养革兰氏阴性杆菌呈阳性。培养48小时后,血琼脂培养基上的传代培养物长出了纯的黄色、不发酵、革兰氏阴性、杆状细菌。该微生物氧化酶和七叶苷水解试验呈阳性,而尿素、硝酸盐还原及枸橼酸盐利用试验呈阴性。动力试验也为阴性。使用法国生物梅里埃公司的mini API系统将该分离株鉴定为少动鞘氨醇单胞菌。同时用该系统进行了药敏试验,发现该菌株对头孢他啶、头孢曲松、头孢哌酮、头孢吡肟、头孢噻肟、环丙沙星、亚胺培南、哌拉西林 - 他唑巴坦、氨曲南、阿米卡星和庆大霉素敏感。开始静脉注射头孢曲松(2×750毫克/天)治疗。他对治疗反应良好,于第十天出院。报告此病例是为了强调应将少动鞘氨醇单胞菌视为医院感染病原体,并应根据药敏试验结果进行治疗。