Kato K, Matsumura Y, Yamamoto M, Nagao M, Ito Y, Takakura S, Ichiyama S
Department of Clinical Laboratory Medicine, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawaharacho, Sakyo-ku, Kyoto, 606-8507, Japan.
Eur J Clin Microbiol Infect Dis. 2014 Aug;33(8):1371-9. doi: 10.1007/s10096-014-2083-1. Epub 2014 Mar 3.
Bacillus cereus, an opportunistic pathogen, can cause fatal infection. However, B. cereus bloodstream infections (BSIs) have not been well characterised. From 2008 to 2013, B. cereus isolates from all of the specimens and patients with B. cereus BSIs were identified. Environmental samples were collected to detect B. cereus contamination. We also characterised the clinical presentation of B. cereus BSI through analyses of risk factors for BSI and mortality. A total of 217 clinical B. cereus isolates was detected. Fifty-one patients with nosocomial infections were diagnosed as B. cereus BSI, and 37 had contaminated blood cultures. The number of B. cereus isolates and BSI patients was significantly greater from June to September than from January to April (4.9 vs. 1.5 per month and 1.2 vs. 0.2, respectively). All BSIs were nosocomial and related to central or peripheral vascular catheter. Urinary catheter [odds ratio (OR) 6.93, 95% confidence interval (CI) 2.40-20.0] was the independent risk factor associated with BSI patients when compared to patients regarded as contaminated. In-hospital mortality among BSI patients was 20% and was associated with urinary catheter (OR 34.7, 95 % CI 1.89-63.6) and higher Charlson index (OR 1.99, 95 % CI 1.26-3.12). The number of B. cereus isolates and BSI increased during summer. Inpatients with indwelling vascular or urinary catheters should be carefully monitored for potential B. cereus BSIs.
蜡样芽孢杆菌是一种机会致病菌,可导致致命感染。然而,蜡样芽孢杆菌血流感染(BSIs)的特征尚未得到充分描述。2008年至2013年,对所有蜡样芽孢杆菌BSIs标本和患者的蜡样芽孢杆菌分离株进行了鉴定。收集环境样本以检测蜡样芽孢杆菌污染情况。我们还通过分析BSIs的危险因素和死亡率来描述蜡样芽孢杆菌BSI的临床表现。共检测到217株临床蜡样芽孢杆菌分离株。51例医院感染患者被诊断为蜡样芽孢杆菌BSI,37例血培养被污染。6月至9月蜡样芽孢杆菌分离株和BSI患者的数量明显多于1月至4月(分别为每月4.9株对1.5株和1.2例对0.2例)。所有BSIs均为医院感染,且与中心或外周血管导管相关。与被视为血培养污染的患者相比,导尿管(优势比[OR]6.93,95%置信区间[CI]2.40 - 20.0)是与BSI患者相关的独立危险因素。BSI患者的院内死亡率为20%,与导尿管(OR 34.7,95%CI 1.89 - 63.6)和较高的查尔森指数(OR 1.99,95%CI 1.26 - 3.12)相关。夏季蜡样芽孢杆菌分离株和BSI的数量增加。应密切监测留置血管或导尿管的住院患者是否有潜在的蜡样芽孢杆菌BSIs。