Division of Infectious Diseases, Box 1090, Mount Sinai School of Medicine, One Gustave L. Levy Place, New York, NY 10029, USA.
Clin Microbiol Rev. 2010 Apr;23(2):382-98. doi: 10.1128/CMR.00073-09.
Bacillus cereus is a Gram-positive aerobic or facultatively anaerobic, motile, spore-forming, rod-shaped bacterium that is widely distributed environmentally. While B. cereus is associated mainly with food poisoning, it is being increasingly reported to be a cause of serious and potentially fatal non-gastrointestinal-tract infections. The pathogenicity of B. cereus, whether intestinal or nonintestinal, is intimately associated with the production of tissue-destructive exoenzymes. Among these secreted toxins are four hemolysins, three distinct phospholipases, an emesis-inducing toxin, and proteases. The major hurdle in evaluating B. cereus when isolated from a clinical specimen is overcoming its stigma as an insignificant contaminant. Outside its notoriety in association with food poisoning and severe eye infections, this bacterium has been incriminated in a multitude of other clinical conditions such as anthrax-like progressive pneumonia, fulminant sepsis, and devastating central nervous system infections, particularly in immunosuppressed individuals, intravenous drug abusers, and neonates. Its role in nosocomial acquired bacteremia and wound infections in postsurgical patients has also been well defined, especially when intravascular devices such as catheters are inserted. Primary cutaneous infections mimicking clostridial gas gangrene induced subsequent to trauma have also been well documented. B. cereus produces a potent beta-lactamase conferring marked resistance to beta-lactam antibiotics. Antimicrobials noted to be effective in the empirical management of a B. cereus infection while awaiting antimicrobial susceptibility results for the isolate include ciprofloxacin and vancomycin.
蜡样芽胞杆菌是一种革兰氏阳性需氧或兼性厌氧、运动、产芽孢的杆状细菌，广泛分布于环境中。虽然蜡样芽胞杆菌主要与食物中毒有关，但它越来越多地被报道为严重和潜在致命的非胃肠道感染的原因。蜡样芽胞杆菌的致病性，无论是肠道还是非肠道，都与产生组织破坏性外毒素密切相关。在这些分泌的毒素中，有四种溶血素、三种不同的磷脂酶、一种引起呕吐的毒素和蛋白酶。从临床标本中分离出蜡样芽胞杆菌时，主要的障碍是克服其作为无足轻重的污染物的污名。除了因与食物中毒和严重眼部感染有关而声名狼藉外，这种细菌还被牵连到许多其他临床病症中，如炭疽样进行性肺炎、暴发性败血症和毁灭性的中枢神经系统感染，特别是在免疫功能低下的个体、静脉药物滥用者和新生儿中。它在医院获得性菌血症和术后患者伤口感染中的作用也已得到明确界定，特别是在插入血管内装置（如导管）时。因创伤引起的类似于梭状芽胞杆菌气性坏疽的原发性皮肤感染也有很好的记录。蜡样芽胞杆菌产生一种有效的β-内酰胺酶，赋予对β-内酰胺类抗生素的显著耐药性。在等待分离物的抗菌敏感性结果时，被认为对蜡样芽胞杆菌感染进行经验性管理有效的抗菌药物包括环丙沙星和万古霉素。
