McMahon D K, Dummer J S, Pasculle A W, Cassell G
Department of Medicine, University of Pittsburgh School of Medicine, Pennsylvania.
Am J Med. 1990 Sep;89(3):275-81. doi: 10.1016/0002-9343(90)90338-e.
To heighten awareness of the role of Mycoplasma hominis as an extragenital pathogen in adults.
Patients ranged in age from 14 to 76 years. Thirteen patients were immunosuppressed, including nine organ transplant recipients; three were receiving steroids, and two had an underlying malignancy. The remainder were immunocompetent. Thirteen patients had prior surgery at or near the site of infection. M. hominis was isolated from normally sterile sites such as blood or cerebrospinal, pleural, abdominal and joint fluids, and bone. Non-sterile sites of isolation included surgical wounds and pulmonary secretions. The organism was detected in anaerobic cultures of clinical specimens sent to the laboratory for routine bacteriologic culture. Gram stains of fluids or wound drainage revealed neutrophils but no bacteria. Anti-mycoplasmal therapy was effective in eradicating the organism in 13 of 15 patients who were treated. Of those in whom treatment failed, one patient had an antibiotic-resistant isolate and the other had M. hominis isolated from the lung at postmortem after just 2 days of therapy.
Our experience suggests that significant infections due to M. hominis, although uncommon, are not rare, and methods to isolate and identify this organism should be available for general adult medical and surgical populations.
提高对人型支原体作为成人生殖器外病原体作用的认识。
患者年龄在14至76岁之间。13例患者免疫功能低下,其中包括9例器官移植受者;3例正在接受类固醇治疗,2例患有潜在恶性肿瘤。其余患者免疫功能正常。13例患者在感染部位或其附近曾接受过手术。人型支原体从血液、脑脊液、胸腔积液、腹腔积液、关节液和骨骼等通常无菌的部位分离得到。非无菌分离部位包括手术伤口和肺分泌物。该病原体在送往实验室进行常规细菌培养的临床标本厌氧培养中被检测到。液体或伤口引流液的革兰氏染色显示有中性粒细胞但无细菌。抗支原体治疗对15例接受治疗的患者中的13例有效根除了病原体。在治疗失败的患者中,1例患者分离出的菌株具有抗生素耐药性,另1例患者在治疗仅2天后尸检时从肺部分离出人型支原体。
我们的经验表明,尽管人型支原体引起的严重感染并不常见,但也并非罕见,对于普通成人医疗和外科人群应具备分离和鉴定该病原体的方法。