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一名摄入草甘膦的患者发生第三梭菌败血症。

Clostridium tertium bacteremia in a patient with glyphosate ingestion.

作者信息

You Myung-Jo, Shin Gee-Wook, Lee Chang-Seop

机构信息

Bio-safety Research Institute and College of Veterinary Medicine, Chonbuk National University, Jeonju, Korea.

Department of Internal Medicine and Research Institute of Clinical Medicine, Chonbuk National University Medical School and Hospital, Jeonju, Korea.

出版信息

Am J Case Rep. 2015 Jan 6;16:4-7. doi: 10.12659/AJCR.891287.

Abstract

BACKGROUND

Clostridium tertium is distributed in the soil and in animal and human gastrointestinal tracts. C. tertium has been isolated from patients with blood diseases, immune disorders, and abdominal surgeries. Glyphosate is toxic, causing cause eye and skin irritation, gastrointestinal pain, and vomiting. Ingestion of herbicides modifies the gastrointestinal environment, which stresses the living organisms. However, there has been little attention to cases of bacteremia in patients recovering from suicide attempt by ingesting herbicide.

CASE REPORT

Clostridium tertium was identified in a 44-year-old female who attempted suicide by glyphosate (a herbicide) ingestion. The 16S rRNA sequences from all colonies were 99% identical with that of C. tertium (AB618789) found on a BLAST search of the NCBI database. The bacterium was cultured on TSA under aerobic and anaerobic conditions. Antimicrobial susceptibility tests performed under both aerobic and anaerobic conditions showed that the bacterium was susceptible to penicillin, a combination of β-lactamase inhibitor and piperacillin or amoxicillin, and first- and second- generation cephalosporins. However, it was resistant to third- and fourth-generation cephalosporins.

CONCLUSIONS

Glyphosate herbicide might be a predisposing factor responsible for the pathogenesis of C. tertium. The results highlight the need for careful diagnosis and selection of antibiotics in the treatment of this organism.

摘要

背景

第三梭状芽孢杆菌分布于土壤以及动物和人类的胃肠道中。已从患有血液疾病、免疫紊乱和接受腹部手术的患者中分离出第三梭状芽孢杆菌。草甘膦具有毒性,可导致眼睛和皮肤刺激、胃肠道疼痛和呕吐。摄入除草剂会改变胃肠道环境,给生物带来压力。然而,对于因摄入除草剂自杀未遂后康复的患者发生菌血症的情况关注甚少。

病例报告

在一名44岁因摄入草甘膦(一种除草剂)自杀未遂的女性患者中鉴定出第三梭状芽孢杆菌。对所有菌落的16S rRNA序列进行NCBI数据库BLAST搜索后发现,其与第三梭状芽孢杆菌(AB618789)的序列一致性为99%。该细菌在有氧和厌氧条件下于胰蛋白胨大豆琼脂培养基上培养。在有氧和厌氧条件下进行的药敏试验表明,该细菌对青霉素、β-内酰胺酶抑制剂与哌拉西林或阿莫西林的联合制剂以及第一代和第二代头孢菌素敏感。然而,它对第三代和第四代头孢菌素耐药。

结论

草甘膦除草剂可能是第三梭状芽孢杆菌发病机制的一个诱发因素。结果强调在治疗该菌时需要仔细诊断并选择抗生素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8da9/4289481/345f253586fc/amjcaserep-16-4-g001.jpg

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