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[单核细胞增生李斯特菌人工关节感染:病例报告及文献综述]

[Listeria monocytogenes prosthetic joint infection: Case report and review of the literature].

作者信息

Morchón David, Tejedor Marta, Quereda Carmen, Navas Enrique, Meseguer María

机构信息

Hospital del Río Hortega, Valladolid, España.

出版信息

Enferm Infecc Microbiol Clin. 2009 Aug-Sep;27(7):389-93. doi: 10.1016/j.eimc.2008.05.007. Epub 2009 Jun 17.

Abstract

INTRODUCTION

Listeria monocytogenes is an unusual pathogenic agent in the general population, but is an important cause of bacteriemia and meningoencephalitis among newborns, pregnant women, the elderly population, and immunosuppressed patients. In rare cases, it has been described in joint prosthesis infections.

METHODS

A case description of prosthetic joint infection caused by Listeria in a 74-year-old man is presented. A systematic review of the literature (MEDLINE up to November 2007) was performed, and the reported cases are summarized.

RESULTS

Sixteen cases of prosthetic joint infection by L. monocytogenes have been reported, mainly in patients of advanced age (mean, 67.4 years; mode, 70 years) and immunosuppressed patients. Most cases were late infections.

CONCLUSION

L. monocytogenes should be kept in mind as a pathogen involved in joint prosthesis infection, particularly among the elderly and immunosuppressed populations. Based on the literature review, parenteral ampicillin for at least 6 weeks is the treatment of choice. If possible, prosthesis removal should also be performed.

摘要

引言

单核细胞增生李斯特菌在普通人群中是一种不常见的病原体,但在新生儿、孕妇、老年人群以及免疫抑制患者中却是菌血症和脑膜脑炎的重要病因。在罕见情况下,它也曾在人工关节感染中被描述过。

方法

本文介绍了一名74岁男性由李斯特菌引起的人工关节感染病例。对文献(截至2007年11月的MEDLINE)进行了系统回顾,并总结了报告的病例。

结果

已报告16例由单核细胞增生李斯特菌引起的人工关节感染病例,主要发生在老年患者(平均年龄67.4岁;众数年龄70岁)和免疫抑制患者中。大多数病例为晚期感染。

结论

应将单核细胞增生李斯特菌视为参与人工关节感染的病原体,尤其是在老年和免疫抑制人群中。根据文献综述,至少6周的胃肠外氨苄西林治疗是首选治疗方法。如果可能,还应进行假体移除。

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