Pasticci Maria Bruna, Rinonapoli Giuseppe, Leli Christian, Mencacci Antonella
Infectious Disease Section, Experimental Medicine and Biochemical Sciences, Perugia, Italy.
BMJ Case Rep. 2013 Nov 28;2013:bcr2013201450. doi: 10.1136/bcr-2013-201450.
The commercial real-time PCR SeptiFast test allows identification of 25 bacterial and fungal species directly from peripheral blood in patients with bloodstream infections. A 22-year-old Caucasian woman reported an open femur fracture requiring a two step surgical procedure. After the second procedure the patient manifested sepsis and Enterobacter cloacae/aerogenes DNA was detected in the peripheral blood with the SeptiFast. Thereafter, femur osteomyelitis was diagnosed and E cloacae was cultured from intraoperative bone samples. The patient completed a 3-month course of antimicrobial therapy. Five months after therapy was discontinued, the patient remained symptom free, but delayed bone consolidation occurs. Molecular methods to identify aetiological agents in blood, in addition to conventional cultures, could represent an advantageous tool in clinical practice also in patients with post-traumatic bone infections.
商业实时聚合酶链反应（PCR）SeptiFast检测可直接从血流感染患者的外周血中鉴定出25种细菌和真菌。一名22岁的白种女性因开放性股骨骨折需接受两步外科手术。第二次手术后，患者出现败血症，通过SeptiFast在外周血中检测到阴沟肠杆菌/产气肠杆菌DNA。此后，诊断为股骨骨髓炎，并从术中骨样本中培养出阴沟肠杆菌。患者完成了为期3个月的抗菌治疗疗程。停药5个月后，患者无症状，但出现了骨愈合延迟。除传统培养方法外，采用分子方法鉴定血液中的病原体，对于创伤后骨感染患者而言，在临床实践中也可能是一种有利的工具。
