Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.
J Hosp Infect. 2011 May;78(1):45-9. doi: 10.1016/j.jhin.2010.11.014. Epub 2011 Jan 26.
We studied twenty patients with Leuconostoc spp. bacteraemia at a tertiary hospital in northern Taiwan between 1995 and 2008. All isolates were identified to species level using conventional and commercial automated methods in conjunction with 16S rRNA sequencing analysis. Leuconostoc lactis (15/20, 75%) constituted the most common species but required molecular methods for accurate identification. Minimum inhibitory concentrations (MICs) of 10 antimicrobial agents were determined using the broth microdilution method. Among these 20 patients, 19 had healthcare-associated Leuconostoc spp. bacteraemia and 11 patients (55%) had underlying malignancies. Eleven had been hospitalised for more than 30 days (median: 32.5 days; range: 0-252 days) before the bacteraemic episode. At the time of bacteraemia, 11 had a Pitt bacteraemia score of ≥ 4 (median: 4; range: 0-7) and 12 had a modified Acute Physiological Assessment and Chronic Health Evaluation (APACHE II) score of ≥ 20 (median: 22; range: 5-37). Azithromycin (MIC: 0.12 μg/mL), moxifloxacin (MIC: 0.25-0.5 μg/mL), daptomycin (MIC: 0.03-0.25 μg/mL) and tigecycline (MIC: 0.06-0.12 μg/mL) exhibited good in vitro activity against Leuconostoc spp. although bacteraemia due to L. lactis was associated with high mortality in immunocompromised patients.
我们研究了 1995 年至 2008 年间在台湾北部一家三级医院发生的 20 例乳球菌属菌血症患者。所有分离株均通过常规和商业自动化方法与 16S rRNA 测序分析相结合来鉴定到种水平。乳球菌属乳球菌（15/20，75%）是最常见的物种，但需要分子方法进行准确鉴定。采用肉汤微量稀释法测定了 10 种抗菌药物的最低抑菌浓度（MIC）。在这 20 例患者中，19 例为医源性乳球菌属菌血症，11 例患者（55%）患有恶性肿瘤。11 例患者在菌血症发生前已住院超过 30 天（中位数：32.5 天；范围：0-252 天）。在发生菌血症时，11 例患者的 Pitt 菌血症评分≥4（中位数：4；范围：0-7），12 例患者的改良急性生理评估和慢性健康评估（APACHE II）评分≥20（中位数：22；范围：5-37）。阿奇霉素（MIC：0.12 μg/mL）、莫西沙星（MIC：0.25-0.5 μg/mL）、达托霉素（MIC：0.03-0.25 μg/mL）和替加环素（MIC：0.06-0.12 μg/mL）对乳球菌属具有良好的体外活性，尽管免疫功能低下患者的乳球菌属乳球菌血症与高死亡率相关。
