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前列腺脓肿引发的PBP-2阴性耐甲氧西林施氏葡萄球菌菌血症:罕见病例

PBP-2 Negative Methicillin Resistant Staphylococcus schleiferi Bacteremia from a Prostate Abscess: An Unusual Occurrence.

作者信息

Merchant Chandni, Villanueva Daphne-Dominique, Lalani Ishan, Eng Margaret, Kang Yong

机构信息

Department of Internal Medicine, Monmouth Medical Center, Long Branch, NJ 07740, USA.

Department of Pathology, Monmouth Medical Center, Long Branch, NJ 07740, USA.

出版信息

Case Rep Infect Dis. 2016;2016:8979656. doi: 10.1155/2016/8979656. Epub 2016 Mar 22.

Abstract

Staphylococcus schleiferi subsp. schleiferi is a coagulase-negative Staphylococcus which has been described as a pathogen responsible for various nosocomial infections including bacteremia, brain abscess, and infection of intravenous pacemakers. Recently, such bacteria have been described to be found typically on skin and mucosal surfaces. It is also believed to be a part of the preaxillary human flora and more frequently found in men. It is very similar in its pathogenicity with Staphylococcus aureus group and expresses a fibronectin binding protein. Literature on this pathogen reveals that it commonly causes otitis among dogs because of its location in the auditory meatus of canines. Also, it has strong association with pyoderma in dogs. The prime concern with this organism is the antibiotic resistance and relapse even after appropriate treatment. Very rarely, if any, cases have been reported about prostatic abscess (PA) with this microbe. Our patient had a history of recurrent UTIs and subsequent PA resulting in S. schleiferi bacteremia in contrast to gram negative bacteremia commonly associated with UTI. This organism was found to be resistant to methicillin, in spite of being negative for PBP2, which is a rare phenomenon and needs further studies.

摘要

施氏葡萄球菌施氏亚种是一种凝固酶阴性葡萄球菌,被描述为可导致包括菌血症、脑脓肿和静脉起搏器感染在内的各种医院感染的病原体。最近,已描述发现此类细菌通常存在于皮肤和粘膜表面。它也被认为是腋下人类菌群的一部分,且在男性中更常见。其致病性与金黄色葡萄球菌群非常相似,并表达一种纤连蛋白结合蛋白。关于这种病原体的文献表明,由于其存在于犬类的耳道中,它通常会导致犬类中耳炎。此外,它与犬类脓皮病有很强的关联。对这种微生物的主要关注是抗生素耐药性以及即使经过适当治疗后仍会复发。关于这种微生物导致前列腺脓肿(PA)的病例极少被报道。与通常与尿路感染相关的革兰氏阴性菌血症不同,我们的患者有复发性尿路感染病史,随后发生PA并导致施氏葡萄球菌菌血症。尽管该菌PBP2呈阴性,但发现它对甲氧西林耐药,这是一种罕见现象,需要进一步研究。

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