Ariza-Prota Miguel Angel, Pando-Sandoval Ana, Fole-Vázquez David, García-Clemente Marta, Budiño Teresa, Casan Pere
Hospital Universitario Central de Asturias (HUCA), Instituto Nacional de Silicosis (INS), Área del Pulmón, Facultad de Medicina, Universidad de Oviedo, Avenida Roma s/n, Oviedo, Asturias, 33011, Spain.
J Med Case Rep. 2015 Nov 20;9:262. doi: 10.1186/s13256-015-0753-y.
Streptomyces spp. are aerobic, Gram-positive bacteria of the order Actinomycetales, known for their ability to produce antimicrobial molecules such as streptomycin. Pneumonia due to Streptomyces is considered to be rare and limited to immunocompromised patients. Streptomyces spp. are only rarely associated with invasive systemic infections. To our knowledge, we report the first documented case of community-acquired Streptomyces atratus bacteremic pneumonia in an immunocompetent patient.
We describe a case of Streptomyces atratus bacteremic pneumonia in an otherwise healthy, 77-year-old Spanish man. Streptomyces identified by 16S ribosomal RNA sequencing grew in multiple blood cultures and bronchoalveolar lavage cultures. The infection resolved completely after treatment with imipenem and amoxicillin/clavulanic acid for 2 months.
The majority of cases reported in the literature make reference to the difficulty of determining the pathogenic role of Streptomyces spp. Usually considered a contaminant, the pathogenic role of Streptomyces spp. is easier to confirm when the species is isolated from a catheter tip and, in the case of blood cultures, in more than one sample with a high count of colonies. To our knowledge, we report the first documented case of Streptomyces atratus bacteremic pneumonia in an immunocompetent patient. As the experience is limited, further studies are needed to better understand the interpretation of the isolates of the genus Streptomyces; the predisposing factors for infection; and the course, treatment, and evolution of these infections.
链霉菌属是放线菌目需氧革兰氏阳性菌，以其产生链霉素等抗菌分子的能力而闻名。链霉菌引起的肺炎被认为较为罕见，且仅限于免疫功能低下的患者。链霉菌属很少与侵袭性全身感染相关。据我们所知，我们报告了首例有文献记载的免疫功能正常患者社区获得性阿特拉链霉菌菌血症性肺炎病例。
我们描述了一例77岁西班牙男性阿特拉链霉菌菌血症性肺炎病例，该患者除上述疾病外身体健康。通过16S核糖体RNA测序鉴定的链霉菌在多次血培养和支气管肺泡灌洗培养中生长。用亚胺培南和阿莫西林/克拉维酸治疗2个月后感染完全消退。
文献中报道的大多数病例都提到了确定链霉菌属致病作用的困难。链霉菌属通常被认为是一种污染物，当从导管尖端分离出该菌种时，以及在血培养中，从多个菌落计数高的样本中分离出该菌种时，其致病作用更容易得到证实。据我们所知，我们报告了首例有文献记载的免疫功能正常患者阿特拉链霉菌菌血症性肺炎病例。由于经验有限，需要进一步研究以更好地理解链霉菌属分离株的解读、感染的易感因素以及这些感染的病程、治疗和演变。
