Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.
Eur J Clin Microbiol Infect Dis. 2011 Oct;30(10):1185-91. doi: 10.1007/s10096-011-1210-5. Epub 2011 Apr 3.
We investigated clinical and microbiological characteristics of 30 patients with Brevundimonas bacteremia treated at a tertiary care hospital in Taiwan during 2000-2010. All the 30 bacteria isolates were confirmed to the species level by 16S rRNA sequencing analysis. Minimum inhibitory concentrations (MICs) of 11 antimicrobial agents against these isolates were determined by the agar dilution method. Seventeen (57%) patients had underlying malignancy, 12 (40%) had undergone central catheter placement, and 13 (43%) had received chemotherapy within the previous three months. Eight (27%) patients had community-acquired bacteremia and the remaining 22 patients (73%) had healthcare-associated bacteremia. The overall 14-day and 30-day mortality rates were 13% and 17%, respectively. Among the 30 isolates, B. vesicularis constituted most commonly (n = 22, 63%), followed by B. nasdae (n = 5) and B. diminuta (n = 3). All isolates were susceptible to piperacillin-tazobactam and amikacin, while all were resistant to ciprofloxacin and colistin. Tigecycline (MICs at which 90% of isolates are inhibited [MIC(90)] was 0.12 mg/L) and doripenem (MIC(90) of 1 mg/L) both possessed good in vitro activities. In conclusions, Brevundimonas should be considered a pathogen that can cause bacteremia in immunocompromised hosts. Piperacillin-tazobactam, amikacin, doripenem, and tigecycline exhibit good in vitro activities against these ciprofloxacin- and colistin-resistant Brevundimonas species.
我们研究了 2000-2010 年期间在台湾一家三级保健医院治疗的 30 例 Brevundimonas 菌血症患者的临床和微生物学特征。所有 30 株细菌分离株均通过 16S rRNA 测序分析确定到种的水平。通过琼脂稀释法测定这些分离株对 11 种抗菌药物的最小抑菌浓度(MIC)。17 例(57%)患者存在潜在恶性肿瘤,12 例(40%)接受过中心导管放置,13 例(43%)在过去三个月内接受过化疗。8 例(27%)为社区获得性菌血症,其余 22 例(73%)为医疗保健相关菌血症。总的 14 天和 30 天死亡率分别为 13%和 17%。在 30 株分离株中,Brevundimonas vesicularis 最为常见(n=22,63%),其次是 B. nasdae(n=5)和 B. diminuta(n=3)。所有分离株均对哌拉西林-他唑巴坦和阿米卡星敏感,而所有分离株均对环丙沙星和粘菌素耐药。替加环素(MIC90 抑制 90%分离株的浓度 [MIC90]为 0.12mg/L)和多利培南(MIC90 为 1mg/L)均具有良好的体外活性。总之,Brevundimonas 应被认为是一种可引起免疫功能低下宿主菌血症的病原体。哌拉西林-他唑巴坦、阿米卡星、多利培南和替加环素对这些耐环丙沙星和粘菌素的 Brevundimonas 种具有良好的体外活性。