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1例成人感染琼氏不动杆菌的尿路感染病例报告。

An adult case of urinary tract infection with Kingella kingae: a case report.

作者信息

Ramana Kv, Mohanty Sk

机构信息

Department of Microbiology, Kamineni Institute of Medical Sciences (KIMS) Narketpally, Nalgonda-508254 India.

出版信息

J Med Case Rep. 2009 May 11;3:7236. doi: 10.1186/1752-1947-3-7236.

Abstract

INTRODUCTION

Kingella kingae, though part of the normal upper respiratory tract and genitourinary tract, is increasingly being recognized as an important human pathogen. During the past decade, it has emerged as a significant pathogen in the pediatric age group primarily causing bacteremia and osteoarticular infections. Adult infection usually occurs in individuals who are severely immunocompromised and most infections have taken the form of septicemia or septic arthritis. Bacteremia due to K. kingae has been reported as the immediate cause of death in patients with acquired immunodeficiency syndrome.

CASE PRESENTATION

We present a microbiologically confirmed urinary tract infection with K. kingae in an immunocompetent 45-year-old adult woman with post-menopausal bleeding and with a history of clots. Her urine was subjected to culture and sensitivity tests. The isolated colonies were identified as K. kingae because of their typical culture characteristics such as long incubation period required for growth, beta-hemolysis, positive oxidase and negative catalase, urease indole, nitrate and citrate tests. Penicillin G disc test was positive. They were sensitive to all conventional antibiotics.

CONCLUSION

K. kingae infection is a rare occurrence in immunocompetent adults. Very few cases of microbiologically confirmed infections have been reported so far. The isolation of K. kingae from urine sample has rarely been reported. K. kingae isolates are either missed or misinterpreted by clinical microbiologists. Therefore, K. kingae deserves recognition as a pathogen.

摘要

引言

金氏金杆菌虽然是正常上呼吸道和泌尿生殖道的一部分,但越来越被认为是一种重要的人类病原体。在过去十年中,它已成为儿童年龄组中的一种重要病原体,主要引起菌血症和骨关节炎感染。成人感染通常发生在严重免疫功能低下的个体中,大多数感染表现为败血症或化脓性关节炎。据报道,金氏金杆菌引起的菌血症是获得性免疫缺陷综合征患者死亡的直接原因。

病例报告

我们报告一例微生物学确诊的金氏金杆菌引起的尿路感染,患者为一名45岁免疫功能正常的成年女性,有绝经后出血和血凝块病史。对其尿液进行了培养和药敏试验。分离出的菌落因其典型的培养特征,如生长所需的潜伏期长、β溶血、氧化酶阳性、过氧化氢酶阴性、脲酶吲哚、硝酸盐和柠檬酸盐试验阴性,而被鉴定为金氏金杆菌。青霉素G纸片试验呈阳性。它们对所有常规抗生素敏感。

结论

金氏金杆菌感染在免疫功能正常的成年人中很少见。迄今为止,很少有微生物学确诊感染的病例报道。从尿液样本中分离出金氏金杆菌的情况很少被报道。临床微生物学家要么漏检金氏金杆菌分离株,要么对其解读错误。因此,金氏金杆菌应被视为一种病原体。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/693a/2726550/dd2907c4627e/1752-1947-0003-0000007236-1.jpg

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