Yıldız Başak, Duyu Muhterem, Sözeri Betül, Karapınar Bülent
Departments of Pediatric Infectious Diseases, Ege University Faculty of Medicine, İzmir, Turkey.
Turk J Pediatr. 2012 Nov-Dec;54(6):664-6.
Burkholderia cepacia belongs to a family of Burkholderia species previously described as Pseudomonas cepacia, especially in patients suffering from cystic fibrosis. There are also many studies about this agent in the last decade due to their life-threatening infections and ability to invade mucosal and cellular surfaces. Here, we report a case of soft tissue infection caused by B. cepacia in a child with an underlying condition of polyarteritis nodosa. Her complaints started at two months of age and she was on cyclosporine therapy. She was treated several times because of soft tissue infections especially in her extremities. The most common causative agents were Pseudomonas spp. and Escherichia coli, but recently, another soft tissue infection accompanied by fever and signs of sepsis had developed. All blood, urine and tissue (debrided from the necrotic area) specimens were incubated. Empirical antibiotherapy with clindamycin was started and cyclosporine therapy was discontinued. B. cepacia was grown in the tissue specimen culture and was only susceptible to carbapenems. Meropenem therapy was administered throughout 14 days with a daily dosage of 60 mg/kg, and she was treated successfully at least in this attack of soft tissue infection, which caused more severe sepsis and tissue damage than the previous infections with other agents.
洋葱伯克霍尔德菌属于伯克霍尔德菌属，该菌属以前被称为洋葱假单胞菌，尤其是在患有囊性纤维化的患者中。在过去十年中，由于该菌能引发危及生命的感染以及侵袭黏膜和细胞表面的能力，也有许多关于它的研究。在此，我们报告一例由洋葱伯克霍尔德菌引起的软组织感染病例，患儿患有结节性多动脉炎这一基础疾病。她的症状在两个月大时开始出现，当时正在接受环孢素治疗。她因软组织感染，尤其是四肢的感染，接受过多次治疗。最常见的病原体是假单胞菌属和大肠杆菌，但最近又出现了一次伴有发热和败血症迹象的软组织感染。所有血液、尿液和组织（从坏死区域清创得到）标本均进行了培养。开始使用克林霉素进行经验性抗菌治疗，并停用了环孢素治疗。洋葱伯克霍尔德菌在组织标本培养中生长，且仅对碳青霉烯类药物敏感。美罗培南以每日60mg/kg的剂量持续给药14天，至少在这次软组织感染发作中她得到了成功治疗，此次感染引发的败血症和组织损伤比之前由其他病原体引起的感染更为严重。
