Franco-Cendejas Rafael, Colín-Castro Claudia A, Hernández-Durán Melissa, López-Jácome Luis E, Ortega-Peña Silvestre, Cerón-González Guillermo, Vanegas-Rodríguez Samuel, Mondragón-Eguiluz Jaime A, Acosta-Rodríguez Eduardo
Infectious Diseases Department, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Av. México-Xochimilco #289 Col. Arenal de Guadalupe. Del. Tlalpan, Mexico City, CP, 14389, Mexico.
Hip and Knee Reconstruction Department, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Av. México-Xochimilco #289 Col. Arenal de Guadalupe. Del. Tlalpan, Mexico City, CP, 14389, Mexico.
BMC Infect Dis. 2017 Mar 23;17(1):227. doi: 10.1186/s12879-017-2315-y.
Periprosthetic joint infections are mainly caused by Gram-positive cocci. Leuconostoc mesenteroides is a rare microorganism mainly causing bloodstream infections. At times, it might be confused with another type of cocci and give rise to misdiagnosed infections. Molecular diagnosis and biofilm production comprise important techniques to guide antibiotic treatment.
A 68-year-old Hispanic female with a previous history of bilateral knee arthroplasty presented with acute right-knee inflammation and gait impairment. Blood tests showed inflammatory response and knee x-ray revealed no prosthesis loosening. Irrigation and debridement was performed. Gram-positive cocci were obtained from cultures, and then biochemical and molecular identification revealed L. mesenteroides. Susceptibility and biofilm production were performed. The patient was treated with IntraVenous (IV) Ceftriaxone for ten days and was then switched to Amoxicillin-Clavulanate for 3 months with clinical and laboratory success.
Microbiology diagnosis of fastidious microorganisms is mandatory to treat periprosthetic joint infections adequately. L. mesenteroides may infect non-immunocompromised persons; however, treatment guidelines are lacking.
人工关节周围感染主要由革兰氏阳性球菌引起。肠系膜明串珠菌是一种主要引起血流感染的罕见微生物。有时，它可能会与另一种球菌混淆，导致感染误诊。分子诊断和生物膜形成是指导抗生素治疗的重要技术。
一名68岁有双侧膝关节置换术病史的西班牙裔女性，出现右膝急性炎症和步态障碍。血液检查显示有炎症反应，膝关节X线检查未发现假体松动。进行了冲洗和清创术。从培养物中分离出革兰氏阳性球菌，随后的生化和分子鉴定显示为肠系膜明串珠菌。进行了药敏试验和生物膜形成检测。患者接受静脉注射头孢曲松治疗10天，然后改用阿莫西林-克拉维酸治疗3个月，临床和实验室检查均取得成功。
对于人工关节周围感染的充分治疗，必须对苛养微生物进行微生物学诊断。肠系膜明串珠菌可能感染非免疫功能低下者；然而，目前缺乏治疗指南。
