Department of Surgery, University of Virginia Health System, Charlottesville, Virginia, USA.
Surg Infect (Larchmt). 2012 Feb;13(1):63-6. doi: 10.1089/sur.2010.093. Epub 2012 Jan 4.
Leclercia adecarboxylata is a rarely described gram-negative pathogen. Since the advent of rapid molecular typing techniques, L. adecarboxylata has been described in 23 case reports, often associated with polymicrobial infections or in immunosuppressed hosts.
A case is described and previous cases of L. adecarboxylata infection are reviewed.
A 55-year old male victim of trauma developed septic shock several days after presentation to the emergency department. Blood and central vein catheter cultures grew L. adecarboxylata; Haemophilus influenzae and Streptococcus pneumoniae were present in bronchoalveolar lavage samples. With aggressive hemodynamic and ventilator support in addition to antibiotic therapy, the patient cleared the catheter-related blood stream infection. After a challenging intensive care unit stay, the patient eventually was discharged to an inpatient rehabilitation unit.
An L. adecarboxylata catheter-related blood stream infection developed in the setting of both underlying immunosuppression and polymicrobial infection. As molecular typing techniques continue to improve, L. adecarboxylata is likely to be an increasingly recognized gram-negative pathogen. Interactions between L. adecarboxylata infection, immunosuppression, and polymicrobial infections remain to be elucidated.
阿克曼氏菌是一种很少被描述的革兰氏阴性病原体。自从快速分子分型技术问世以来，已在 23 例病例报告中描述了阿克曼氏菌，其通常与混合感染或免疫抑制宿主有关。
描述了一个病例，并回顾了以前的阿克曼氏菌感染病例。
一名 55 岁的创伤男性患者在急诊科就诊后数天出现感染性休克。血液和中心静脉导管培养物中生长出阿克曼氏菌；支气管肺泡灌洗液样本中存在流感嗜血杆菌和肺炎链球菌。通过积极的血流动力学和呼吸机支持以及抗生素治疗，患者清除了导管相关的血流感染。在经历了一场具有挑战性的重症监护病房住院治疗后，患者最终被转至住院康复病房。
在存在潜在免疫抑制和混合感染的情况下，发生了阿克曼氏菌导管相关血流感染。随着分子分型技术的不断改进，阿克曼氏菌可能成为一种越来越被认可的革兰氏阴性病原体。阿克曼氏菌感染、免疫抑制和混合感染之间的相互作用仍有待阐明。
