Kikuchi Taku, Mori Takehiko, Kohashi Sumiko, Yamane Yusuke, Okayama Mikio, Mashima Eri, Murakami Koichi, Shimizu Takayuki, Kurihara Yuichi, Ueda Tomomi, Suzuki Takeshi, Okamoto Shinichiro
Division of Hematology, Department of Medicine, Keio University School of Medicine.
Rinsho Ketsueki. 2016 Feb;57(2):175-9. doi: 10.11406/rinketsu.57.175.
Achromobacter xylosoxidans (A. xylosoxidans) is a non-fermentative gram-negative rod. This organism is reportedly a causative pathogen of bacteremia mainly in patients with hematological disorders. However, only one case of cellulitis due to A. xylosoxidans associated with hematological malignancy has been reported. An 80-year-old man developed cellulitis and subsequent bacteremia due to A. xylosoxidans during bortezomib therapy for multiple myeloma. Although his condition was serious enough to require intensive care, he fully recovered with appropriate antimicrobial agents and supportive care. The isolate was broadly resistant to antimicrobial agents, including cefepime, amikacin, and ciprofloxacin. Therefore, the identification and selection of appropriate antimicrobial agents were considered to have contributed to the successful outcome in this case. Physicians should recognize A. xylosoxidans as a possible pathogen causing cellulitis and secondary bacteremia, as well as being aware of its broad resistance to antimicrobial agents.
木糖氧化无色杆菌(A. xylosoxidans)是一种非发酵革兰氏阴性杆菌。据报道,这种微生物主要是血液系统疾病患者菌血症的致病病原体。然而,仅有一例与血液系统恶性肿瘤相关的木糖氧化无色杆菌引起蜂窝织炎的病例报道。一名80岁男性在接受硼替佐米治疗多发性骨髓瘤期间,因木糖氧化无色杆菌发生蜂窝织炎及随后的菌血症。尽管他的病情严重到需要重症监护,但通过适当的抗菌药物和支持治疗后完全康复。该分离株对包括头孢吡肟、阿米卡星和环丙沙星在内的抗菌药物具有广泛耐药性。因此,认为对合适抗菌药物的识别和选择促成了该病例的成功治疗。医生应认识到木糖氧化无色杆菌是引起蜂窝织炎和继发性菌血症的可能病原体,并意识到其对抗菌药物的广泛耐药性。