Fica C Alberto, Porte T Lorena, Braun J Stephanie, Veas P Nicolás, Pavez A Claudia, Dabanch P Jeannette, Morales I Ricardo
Servicio de Infectología, Departamento de Medicina, Hospital Militar de Santiago, Chile.
Rev Chilena Infectol. 2011 Jun;28(3):211-6. Epub 2011 Jul 14.
Six cases of bacteremia and one of endarteritis were identified between 1986 and 2010 in a general hospital in Chile. Five of these cases occurred during the second half of this timeframe, Campylobacter fetus predominated (5 out of 7) and the majority of the infections presented during warmer months. The mean age was 32.4 years (range 19 to 63) all had comorbidities, and main clinical manifestations included fever with diarrhea. Four patients developed hypotension and two septic shock. The latter, associated to C. fetus bacteremia, died before microbiological diagnosis. Six out of 7 patients received antimicrobial therapy. During 2004 and 2010, the rates of Campylobacter spp. positive stool cultures in the same hospital increased 4 times, suggesting an emerging profile. Bacteremia and endarteritis by Campylobacter spp. can develop in vulnerable patients and manifest as fever with or without diarrhea. Finding curved or spiral shaped gram negative rods in blood cultures leads to suspect this pathogen. Species identification is of utmost importance due to antimicrobial resistance especially in C. jejuni. Prognosis is unfavorable due to host characteristics, and case-fatality rate is high.
1986年至2010年间,智利一家综合医院确诊了6例菌血症和1例动脉内膜炎。其中5例发生在这一时间段的后半期,胎儿弯曲杆菌占主导(7例中的5例),且大多数感染发生在温暖月份。平均年龄为32.4岁(范围19至63岁),所有患者均有合并症,主要临床表现包括发热伴腹泻。4例患者出现低血压,2例发生感染性休克。后者与胎儿弯曲杆菌菌血症相关,在微生物学诊断前死亡。7例患者中有6例接受了抗菌治疗。2004年至2010年期间,同一家医院弯曲杆菌属粪便培养阳性率增加了4倍,提示出现了一种新的情况。弯曲杆菌属引起的菌血症和动脉内膜炎可在易感患者中发生,表现为有或无腹泻的发热。在血培养中发现弯曲或螺旋状革兰氏阴性杆菌会使人怀疑这种病原体。由于抗菌药物耐药性,尤其是空肠弯曲杆菌的耐药性,菌种鉴定至关重要。由于宿主特征,预后不佳,病死率很高。