病例报告：当两个半男人去露营时……
Case report: when two and ½ men go camping….
作者信息
von Rotz Matthias, Dierig Alexa, Heininger Ulrich, Chrobak Carl, Baettig Veronika, Egli Adrian
机构信息
Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Basel, Switzerland.
Department of Internal Medicine, University Hospital Basel, Basel, Switzerland.
出版信息
BMC Infect Dis. 2017 Jan 30;17(1):102. doi: 10.1186/s12879-017-2213-3.
BACKGROUND
In patients, rapid identification of bacterial species may help to guide treatment at early stages. New protocols for the identification directly from positive blood culture flasks significantly helped in the presented case report.
CASE PRESENTATION
Two patients (a father and son) presented with diarrhea, malaise, and fever of 3 to 4 days duration. Blood cultures from both patients cultured short Gram-positive rods. MALDI-TOF based rapid identification protocol direct from positive blood culture identified Listeria monocytogenes as the cause of sepsis and could be confirmed with conventional methods. Listeria monocytogenes was identified 24 h later by conventional biochemical identification methods (VITEK 2). Antibiotic treatment was adjusted early in response to the MALDI-TOF based identification of bacteremia. Pulsed field gel electrophoresis confirmed the suspected relatedness of the father's and son's isolates.
CONCLUSIONS
MALDI-TOF based may provide a rapid identification of bacterial species directly from positive blood culture.
背景
对于患者而言，快速鉴定细菌种类有助于在早期阶段指导治疗。在本病例报告中，直接从阳性血培养瓶中进行鉴定的新方案发挥了显著作用。
病例介绍
两名患者（父子）出现腹泻、不适及持续3至4天的发热症状。两名患者的血培养均培养出短革兰氏阳性杆菌。基于基质辅助激光解吸电离飞行时间质谱（MALDI-TOF）的直接从阳性血培养中进行快速鉴定方案确定单核细胞增生李斯特菌为败血症病因，且可用传统方法予以证实。通过传统生化鉴定方法（VITEK 2）在24小时后鉴定出单核细胞增生李斯特菌。根据基于MALDI-TOF的菌血症鉴定结果，早期调整了抗生素治疗方案。脉冲场凝胶电泳证实了父子二人分离株之间存在疑似相关性。
结论
基于MALDI-TOF的方法可直接从阳性血培养中快速鉴定细菌种类。
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