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[一名囊性纤维化患者的嗜麦芽窄食单胞菌定植]

[Pandoraea sputorum colonization in a patient with cystic fibrosis].

作者信息

Martínez-Lamas Lucía, Rabade Castedo Carlos, Martín Romero Domínguez Miguel, Barbeito Castiñeiras Gema, Palacios Bartolomé Ana, Pérez Del Molino Bernal María Luisa

机构信息

Servicio de Microbiología y Parasitología, Complexo Hospitalario Universitario de Santiago de Compostela, La Coruña, España. lu

出版信息

Arch Bronconeumol. 2011 Nov;47(11):571-4. doi: 10.1016/j.arbres.2011.06.015. Epub 2011 Sep 9.

Abstract

Cystic fibrosis (CF) is a disease produced by a defect in the transmembrane conductance regulator protein, CFTR. Currently, the morbidity and mortality associated with CF are fundamentally related with the lung affectation that is a consequence of this defect. With the progression of the disease, there is an increase in the isolation of non-fermenting gram-negative bacilli colonizing these patients. The genus Pandoraea arises from a reclassification of species included within the "Burkholderia cepacia complex". It is made up of 9 species susceptible only to tetracycline, imipenem and cotrimoxazole. We report the first clinical case in Spain of colonization by Pandoraea sputorum in a patient diagnosed with CF at the age of eleven. After several previous colonizations by different Pseudomonas species in September 2005, a gram-negative bacillus was isolated in sputum, which was identified by sequencing and mass spectrometry (MALDITOF-MS) as P. sputorum, only sensitive to piperacillin-tazobactam, cotrimoxazole and imipenem. From 2005 to 2008, chronic colonization by this microorganism was associated with deterioration in lung function that was recuperated after treatment with piperacillin-tazobactam and imipenem. In 2010, this microorganism was once again isolated and treated with imipenem, to which the patient responded favorably. Currently, it is not known whether this microorganism is a chronic colonizer, whether it produces a transitory infection or whether it constitutes an important problem in CF patients, but given its special characteristics of sensitivity to anti-microbial drugs, the correct identification of this genus is essential. Mass spectrometry seems to be a valid technique that is faster than sequencing methods for identifying these species.

摘要

囊性纤维化(CF)是一种由跨膜电导调节蛋白CFTR缺陷引起的疾病。目前,与CF相关的发病率和死亡率主要与肺部受累有关,而肺部受累是这种缺陷的后果。随着疾病的进展,定植于这些患者的非发酵革兰氏阴性杆菌的分离率有所增加。潘多拉菌属源于对“洋葱伯克霍尔德菌复合体”中所含物种的重新分类。它由9个物种组成,仅对四环素、亚胺培南和复方新诺明敏感。我们报告了西班牙首例11岁确诊为CF的患者被斯氏潘多拉菌定植的临床病例。2005年9月该患者先前曾被不同的假单胞菌属物种定植过几次,之后在痰液中分离出一种革兰氏阴性杆菌,通过测序和质谱分析(基质辅助激光解吸电离飞行时间质谱,MALDITOF-MS)鉴定为斯氏潘多拉菌,该菌仅对哌拉西林-他唑巴坦、复方新诺明和亚胺培南敏感。从2005年到2008年,该微生物的慢性定植与肺功能恶化相关,在用哌拉西林-他唑巴坦和亚胺培南治疗后肺功能得到恢复。2010年,再次分离出该微生物并用亚胺培南治疗,患者对此反应良好。目前尚不清楚这种微生物是慢性定植菌、是否引起短暂感染还是在CF患者中构成重要问题,但鉴于其对抗菌药物敏感性的特殊特征,正确鉴定该菌属至关重要。质谱分析似乎是一种有效的技术,比测序方法更快地鉴定这些物种。

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