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索氏梭菌作为一名33岁亚洲产后女性致命性中毒性休克综合征的罕见病因,以及普通女性人群产前筛查该梭菌属的必要性。

Clostridium Sordellii as an Uncommon Cause of Fatal Toxic Shock Syndrome in a Postpartum 33-Year-Old Asian Woman, and the Need for Antepartum Screening for This Clostridia Species in the General Female Population.

作者信息

Guzzetta Melissa, Williamson Alex, Duong Scott

机构信息

Department of Pathology and Laboratory Medicine, Hofstra Northwell School of Medicine, Lake Success, NY

Department of Pathology and Laboratory Medicine, Hofstra Northwell School of Medicine, Lake Success, NY.

出版信息

Lab Med. 2016 Aug;47(3):251-4. doi: 10.1093/labmed/lmw025. Epub 2016 Jul 1.

Abstract

Clostridium sordellii (C. sordellii) is an anaerobic gram-positive rod most commonly found in the soil and sewage but also as part of the normal flora of the gastrointestinal tract and vagina of a small percentage of healthy individuals. C. sordellii infection is considered to result from childbirth, abortion, and/or gynecological procedures. Although many strains of C. sordellii are nonpathogenic, virulent toxin-producing strains exist. Infection with this organism typically manifests as a patient experiencing septic shock rapidly followed by end-organ failure. Identification of C. sordelli has been successful by traditional culture, mass spectrometry methods, and via molecular methods. Herein, we present a fatal case of C. sordellii infection of a postpartum 33-year-old Asian woman. The organism was isolated by culture and identified using matrix-assisted laser desorption/ionization-time-of-flight (MALDI-TOF) technology. With the advent of rapid detection methods, antepartum screening for the fatal Clostridium species should be implemented in the general female population.

摘要

索氏梭菌(C. sordellii)是一种厌氧革兰氏阳性杆菌,最常见于土壤和污水中,但在一小部分健康个体的胃肠道和阴道正常菌群中也可发现。索氏梭菌感染被认为是由分娩、流产和/或妇科手术引起的。虽然许多索氏梭菌菌株无致病性,但存在产生毒性毒素的菌株。感染这种微生物通常表现为患者迅速出现感染性休克,随后出现终末器官衰竭。通过传统培养、质谱方法和分子方法已成功鉴定出索氏梭菌。在此,我们报告一例33岁亚洲产后妇女索氏梭菌感染致死病例。通过培养分离出该微生物,并使用基质辅助激光解吸/电离飞行时间(MALDI-TOF)技术进行鉴定。随着快速检测方法的出现,应在一般女性人群中开展对致命梭菌物种的产前筛查。

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