Izzo Ilaria, Lania Donatella, Castro Antonino, Lanzini Fernanda, Bella Daniele, Pagani Adriano, Colombini Paolo
UOSC Medicina Generale; Gruppo operativo per il controllo delle infezioni ospedaliere; UOSD Oncologia; UOSC Laboratorio analisi, AO Mellino Mellini, Chiari (BS), Italy.
Infez Med. 2014 Jun;22(2):152-5.
Pantoea agglomerans, a gram negative bacillus in the Enterobacteriaceae family, has been isolated from feculent material, plants and soil. Soft tissue and bone-joint infections due to P. agglomerans following penetrating trauma by vegetation and bacteraemia in association with intravenous fluid, total parenteral nutrition, blood products and anaesthetic agent contamination have been reported. Between October 2009 and January 2010 seven cases of port a cath contamination caused by P. agglomerans were observed in the Oncological Service of our hospital. All patients presented with septic fever after heparinization of the central venous catheter. 5/7 patients were female; mean age was 67 years (range 58-75). 6/7 patients were affected by colorectal adenocarcinoma, 1/7 by mammarian cancer. Mean time from CVC insertion was 23.8 months (range 13-42) at the time of fever. In three cases, port a cath was removed following the oncologist prescription. P. agglomerans was isolated from the catheter tip in one case and from CVC blood culture in 6-7 cases. In all cases peripheral blood cultures were negative. Patients were treated with ciprofloxacin lock therapy and systemic therapy (per os), obtaining negative cultures from port a cath. Notwithstanding the absence of isolation of Pantoea strains from environmental cultures, after educational intervention, which underlined some faulty procedures in CVC management, no further cases were observed.
成团泛菌是肠杆菌科的革兰氏阴性杆菌，可从粪便、植物和土壤中分离得到。有报道称，成团泛菌可导致因植被穿透性创伤引起的软组织和骨关节感染，以及与静脉输液、全胃肠外营养、血液制品和麻醉剂污染相关的菌血症。2009年10月至2010年1月期间，我院肿瘤科观察到7例由成团泛菌引起的植入式静脉输液港污染病例。所有患者在中心静脉导管肝素化后均出现败血症热。7例患者中有5例为女性；平均年龄为67岁（范围58 - 75岁）。7例患者中有6例患有结肠腺癌，1例患有乳腺癌。发热时距中心静脉导管插入的平均时间为23.8个月（范围13 - 42个月）。3例患者根据肿瘤学家的处方拔除了植入式静脉输液港。1例从导管尖端分离出成团泛菌，6 - 7例从中心静脉导管血培养中分离出该菌。所有病例外周血培养均为阴性。患者接受环丙沙星封管治疗和全身治疗（口服），植入式静脉输液港培养结果转为阴性。尽管环境培养未分离出泛菌菌株，但在强调了中心静脉导管管理中的一些错误操作的教育干预后，未再观察到新的病例。
