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一株腐败希瓦氏菌引起颅内感染的病例报告

A case report of intracranial infection caused by Shewanella putrefaciens.

作者信息

Duan Mengxi, Wang Dali, Wang Jing, Xiao Xiaoguang, Han Lixia, Zhang Fenghua

机构信息

Department of Clinical Laboratory, The First Affiliated Hospital of Dalian Medical University, 116011, Dalian, China,

出版信息

Neurol Sci. 2015 Apr;36(4):625-9. doi: 10.1007/s10072-014-1956-5. Epub 2014 Sep 26.

Abstract

Shewanella putrefaciens is as yet reputed to be a rare conditional pathogen. In recent years, some clinical infections caused by Shewanella putrefaciens came into view, and it was possible for the bacteria to be isolated from blood, pus, urine, sputum, and wound secretions, etc. A transferred patient who suffered from intracranial infection after operation of cerebral hemorrhage was admitted in the First Affiliated Hospital of Dalian Medical University. To ascertain the cause, we assessed her blood, cerebrospinal fluid and sputum specimen, and succeeded in isolating one strain of bacteria from her cerebrospinal fluid. To circumvent the potential problem, further detection by Dade Behring Microscan WalkAway 96SI system and drug sensitivity identification plate was performed. Corresponding results indicated that the bacteria were certain pseudomonas with high drug resistance, only sensitive to ticarcillin/clavulanic acid and Imipenem. Eventually by 16S rDNA amplification assay, a new technique to identify pathogens genome, Shewanella putrefaciens infection was confirmed with 99 % coincidence rate. This is the first time in our hospital that Shewanella putrefaciens in the cerebrospinal fluid specimen was detected. When considering the increase of opportunistic infection, it is noteworthy to pay more attention to such situations in clinical diagnoses.

摘要

腐败希瓦氏菌至今仍被认为是一种罕见的条件致病菌。近年来,一些由腐败希瓦氏菌引起的临床感染病例逐渐显现,该细菌可从血液、脓液、尿液、痰液及伤口分泌物等中分离出来。大连医科大学附属第一医院收治了一名脑出血术后发生颅内感染的转院患者。为查明病因,我们对其血液、脑脊液和痰液标本进行了检测,并成功从其脑脊液中分离出一株细菌。为避免潜在问题,我们使用达德拜林Microscan WalkAway 96SI系统和药敏鉴定板进行了进一步检测。相应结果表明,该细菌为某种具有高耐药性的假单胞菌,仅对替卡西林/克拉维酸和亚胺培南敏感。最终通过16S rDNA扩增检测法(一种鉴定病原体基因组的新技术),确诊为腐败希瓦氏菌感染,符合率达99%。这是我院首次在脑脊液标本中检测到腐败希瓦氏菌。鉴于机会性感染有所增加,临床诊断中对此类情况应予以更多关注,这一点值得注意。

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