Department of Critical Care Medicine, Tainan Municipal Hospital, Tainan, Taiwan. choudw＠gmail.com
Jpn J Infect Dis. 2011;64(6):520-4.
Ten patients with intensive care unit (ICU)-acquired Chryseobacterium indologenes bacteremia between January 2004 and December 2008 were studied. The primary site of infection was unknown for 80% of the cases. The known primary sites of infection were empyema (10%) and catheter-related bacteremia (10%). Eight patients (80%) had polymicrobial bacteremia, spent more than 21 days in the ICU, and received more than 14 days of broad-spectrum antibiotic therapy prior to the onset of C. indologenes bacteremia. All isolates were 100% susceptible to minocycline and trimethoprim/sulfamethoxazole. Vancomycin, imipenem, piperacillin/tazobactam, ciprofloxacin, and levofloxacin exhibited 0%, 10%, 20%, 30%, and 30%, respectively, susceptibility against this pathogen. All isolates were 100% resistant to ceftazidime, cefepime, meropenem, piperacillin, and amikacin. The 14-day mortality rate was 40%. Our findings suggest that this pathogen should be included among the causes of ICU-acquired bacteremia, especially in patients with a prolonged stay in an ICU or who had received long-term broad-spectrum antibiotic therapy. Extended-spectrum penicillins, third- and fourth-generation cephalosporins, and quinolones had very little or no effect against this pathogen. Therefore, choosing an appropriate antibiotic therapy for this pathogen is very difficult.
2004 年 1 月至 2008 年 12 月期间，研究了 10 例重症监护病房（ICU）获得性 Chryseobacterium indologenes 菌血症患者。80%的病例感染的主要部位不明。已知的感染原发病灶为脓胸（10%）和导管相关菌血症（10%）。80%的患者（8 例）患有混合微生物菌血症，在 ICU 中停留超过 21 天，并在 Chryseobacterium indologenes 菌血症发病前接受了超过 14 天的广谱抗生素治疗。所有分离株对米诺环素和复方磺胺甲噁唑的敏感性为 100%。万古霉素、亚胺培南、哌拉西林/他唑巴坦、环丙沙星和左氧氟沙星对该病原体的敏感性分别为 0%、10%、20%、30%和 30%。所有分离株对头孢他啶、头孢吡肟、美罗培南、哌拉西林和阿米卡星的耐药率均为 100%。14 天死亡率为 40%。我们的研究结果表明，这种病原体应被包括在 ICU 获得性菌血症的病因中，尤其是在 ICU 停留时间较长或长期接受广谱抗生素治疗的患者中。扩展谱青霉素、三代和四代头孢菌素以及喹诺酮类药物对该病原体几乎没有或没有效果。因此，为该病原体选择合适的抗生素治疗非常困难。
