Department of Emergency and Critical Care Medicine, Ohta Nishinouchi Hospital, 2-5-20 Nishinouchi, Koriyama, Fukushima 963-8558, Japan; Department of Emergency and Critical Care Medicine, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
Department of Emergency and Critical Care Medicine, Ohta Nishinouchi Hospital, 2-5-20 Nishinouchi, Koriyama, Fukushima 963-8558, Japan.
Am J Emerg Med. 2014 Jul;32(7):812.e1-3. doi: 10.1016/j.ajem.2013.12.028. Epub 2013 Dec 18.
Anaerobiospirillum succiniciproducens is rarely associated with bacteremia but results in significant mortality. Almost all reported bacteremia cases have occurred in immunocompromised hosts, such as those with alcoholic liver disease, atherosclerosis, recent surgery, malignancies, or acquired immunodeficiency syndrome. We describe here, to our knowledge, the first clinical evidence for A succiniciproducens bacteremia in a healthy man. A 61-year-old man had fallen from a roof and was admitted to our emergency department with severe left flank pain without an external wound. He was given transcatheter arterial embolization for the left kidney injury on the same day, and his condition stabilized. Four days after admission, he had fever without gastrointestinal signs and symptoms. Spiral-shaped, gram-negative anaerobic bacteria were isolated from 2 sets of blood cultures, and the oxidase and catalase test results were negative. The isolated bacteria were different from the Campylobacter spp. On the next day, the bacteria were confirmed as A succiniciproducens by 16S rRNA sequencing. The patient responded to sulbactam/ampicillin. On day 13, the patient was discharged with a 7-day prescription for oral amoxicillin/clavulanate. Six months after admission, the patient was free of recurrent infection. A succiniciproducens bacteremia can occur in healthy adults. When large gram-negative spiral-shaped bacteria are detected, this bacterial species should be considered and differentiated from the Campylobacter spp because A succiniciproducens is often resistant to macrolide antibiotics.
产琥珀酸拟杆菌很少与菌血症相关,但可导致显著的死亡率。几乎所有报道的菌血症病例都发生在免疫功能低下的宿主中,如患有酒精性肝病、动脉粥样硬化、近期手术、恶性肿瘤或获得性免疫缺陷综合征的患者。在此,我们描述了首例健康男性产琥珀酸拟杆菌菌血症的临床证据。一名 61 岁男性从屋顶坠落,因严重左侧腰痛入住我院急诊,无外部伤口。当天他接受了经导管动脉栓塞治疗左肾损伤,病情稳定。入院后 4 天,他出现发热,无胃肠道症状。从 2 套血培养中分离出螺旋形革兰氏阴性厌氧菌,氧化酶和触酶试验结果为阴性。分离出的细菌与弯曲菌属不同。次日,通过 16S rRNA 测序确认该细菌为产琥珀酸拟杆菌。患者对舒巴坦/氨苄西林有反应。入院第 13 天,患者带 7 天疗程的口服阿莫西林/克拉维酸出院。入院 6 个月后,患者未再出现感染复发。产琥珀酸拟杆菌菌血症可发生于健康成年人。当检测到大的革兰氏阴性螺旋形细菌时,应考虑该细菌,并与弯曲菌属相区分,因为产琥珀酸拟杆菌通常对大环内酯类抗生素耐药。