Shrishrimal Kumarpal
Department of Nephrology, Medical College of Wisconsin, Milwaukee, Wisconsin 53226, USA.
Hemodial Int. 2012 Jan;16(1):113-5. doi: 10.1111/j.1542-4758.2011.00586.x.
Bloodstream infections (BSIs) are common in hemodialysis, especially when the access is a catheter. These infections are more commonly gram-positive bacteria or gram-negative bacilli and on some occasions, fungi. Ochrobactrum anthropi and Shewanella putrefaciens are ubiquitous hydrophilic gram-negative bacilli. There have been three cases of O. anthropi BSI reported in hemodialysis patients (one from the United States and two from Vienna) and two cases of S. putrefaciens BSI in hemodialysis patients (one from the United States and the other from Japan). There have been few more cases reported of infections with these bacteria in peritoneal dialysis, especially outside the United States. We present a novel case of a patient with both recurrent O. anthropi and S. putrefaciens BSI complicating hemodialysis. There have been no reports in the literature of such a case. We also discuss the microbiology, clinical features, and the challenging aspects of treatment of such infections.
血流感染（BSIs）在血液透析中很常见，尤其是当血管通路为导管时。这些感染更常见的病原体是革兰氏阳性菌或革兰氏阴性杆菌，某些情况下也有真菌。嗜水气单胞菌和腐败希瓦氏菌是普遍存在的嗜水性革兰氏阴性杆菌。血液透析患者中已有3例嗜水气单胞菌血流感染的报道（1例来自美国，2例来自维也纳），以及2例血液透析患者感染腐败希瓦氏菌血流感染的报道（1例来自美国，另1例来自日本）。腹膜透析患者中感染这些细菌的报道较少，尤其是在美国以外地区。我们报告了1例新病例，一名患者反复发生嗜水气单胞菌和腐败希瓦氏菌血流感染，使血液透析复杂化。文献中尚无此类病例的报道。我们还讨论了此类感染的微生物学、临床特征以及治疗方面的挑战。
