Monteen Megan R, Ponnapula Supriya, Wood G Christopher, Croce Martin A, Swanson Joseph M, Boucher Bradley A, Fabian Timothy C
University of Tennessee Health Science Center, Memphis, TN, USA.
Ann Pharmacother. 2013 Dec;47(12):1736-9. doi: 10.1177/1060028013508745. Epub 2013 Oct 22.
To report a case of Chryseobacterium indologenes ventilator-associated pneumonia (VAP) in a critically ill trauma patient.
This report describes a 66-year-old critically ill trauma patient who developed VAP, which was caused by C indologenes. The patient was injured in a riding lawn mower accident that trapped him underwater in a pond. The patient required surgery for intra-abdominal injuries and was mechanically ventilated in the trauma intensive care unit. On hospital day 5, the patient developed signs and symptoms of VAP. A diagnosis of C indologenes VAP was confirmed based on a quantitative culture from a bronchoscopic bronchoalveolar lavage. The patient's infection was successfully treated with moxifloxacin for 2 days followed by cefepime for 7 days.
Formally known as Flavobacterium indologenes, C indologenes is a Gram-negative bacillus normally found in plants, soil, foodstuffs, and fresh and marine water sources. Recently, worldwide reports of C indologenes infections in humans have been increasing, though reports from the United States are still rare. Bacteremia and pneumonia are the most commonly reported infections, and most patients are immunocompromised. The current case differs from most previous reports because this patient was in the United States and did not have any traditional immunocompromised states (eg, transplant, cancer, HIV/AIDS, or corticosteroid use).
This case report demonstrates that C indologenes can cause VAP in a trauma ICU patient.
报告1例危重症创伤患者发生产吲哚金黄杆菌呼吸机相关性肺炎（VAP）的病例。
本报告描述了1例66岁的危重症创伤患者发生了由产吲哚金黄杆菌引起的VAP。该患者在骑乘割草机时发生意外，被困在池塘水下。患者因腹部损伤需要手术，并在创伤重症监护病房接受机械通气。住院第5天，患者出现VAP的体征和症状。根据支气管镜支气管肺泡灌洗的定量培养结果确诊为产吲哚金黄杆菌VAP。患者的感染先用莫西沙星治疗2天，随后用头孢吡肟治疗7天，感染得到成功治疗。
产吲哚金黄杆菌以前正式名称为产吲哚黄杆菌，是一种革兰氏阴性杆菌，通常存在于植物、土壤、食品以及淡水和海水中。最近，全球范围内关于产吲哚金黄杆菌感染人类的报告不断增加，不过美国的报告仍然很少。菌血症和肺炎是最常报告的感染类型，大多数患者存在免疫功能低下。本病例与之前的大多数报告不同，因为该患者在美国，且没有任何传统免疫功能低下状态（如移植、癌症、HIV/AIDS或使用皮质类固醇）。
本病例报告表明，产吲哚金黄杆菌可在创伤重症监护病房患者中引起VAP。
