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赭黄纤毛菌引起的早产和新生儿败血症。

Premature Labor and Neonatal Septicemia Caused by Capnocytophaga Ochracea.

作者信息

Alhifany Abdullah A, Almangour Thamer A, Tabb Deanne E, Levine David H

机构信息

Department of Pharmacy Practice and Science, University of Arizona College of Pharmacy, Tucson, AZ, USA.

Department of Pharmacotherapy and Experimental Therapeutics, University of North Carolina at Chapel Hill Eshelman School of Pharmacy, Chapel Hill, NC, USA.

出版信息

Am J Case Rep. 2017 Jun 16;18:674-676. doi: 10.12659/ajcr.903824.

Abstract

BACKGROUND Capnocytophaga ochracea is a gram-negative anaerobic organism commonly found in human oral flora. It is characteristically sensitive to beta-lactams and resistant to aminoglycosides. CASE REPORT A 23-year-old woman presented with lower abdominal pain and was admitted for premature labor at 24-weeks of gestation. At presentation, the cervix was closed and the membrane was intact; however, contractions continued, the membrane subsequently ruptured before receiving any steroids or magnesium, and the mother gave birth to a 540-gram female baby. At birth, Apgar scores were 1 at 5 minutes, 1 at 10 minutes, and 2 at 15 minutes. On the fifth day of life, the blood culture grew Capnocytophaga species. Consequently, Cefotaxime was started and ampicillin continued for a total of 14 days; however, on the 6th day, the head ultrasound showed grade 4 intraventricular hemorrhage and a Do Not Resuscitate (DNR) order was placed in the chart. The patient's health continued to deteriorate, having multiple episodes of bradycardia and desaturation until cardiac arrest on the 17th day. CONCLUSIONS Capnocytophaga ochracea was isolated from the blood culture of a preterm neonate. It was thought to be the cause of the premature labor and subsequent neonatal septicemia. This case report suggests that the prevalence of Capnocytophaga infections is most likely underestimated and that additional premature labors and abortions could have been caused by Capnocytophaga infections that were never detected. Hence, more studies are needed to investigate the route of transmission.

摘要

背景 赭黄二氧化碳嗜纤维菌是一种革兰氏阴性厌氧菌,常见于人类口腔菌群。其特点是对β-内酰胺类敏感,对氨基糖苷类耐药。病例报告 一名23岁女性因下腹部疼痛就诊,在妊娠24周时因早产入院。就诊时,宫颈闭合,胎膜完整;然而,宫缩持续,胎膜随后在未接受任何类固醇或镁剂治疗前破裂,母亲产下一名体重540克的女婴。出生时,阿氏评分5分钟时为1分,10分钟时为1分,15分钟时为2分。出生后第5天,血培养生长出二氧化碳嗜纤维菌属菌种。因此,开始使用头孢噻肟并继续使用氨苄西林,共治疗14天;然而,在第6天,头部超声显示4级脑室内出血,病历中下达了“不要复苏”(DNR)医嘱。患者健康状况持续恶化,多次出现心动过缓和血氧饱和度下降,直至第17天心脏骤停。结论 从一名早产新生儿的血培养中分离出赭黄二氧化碳嗜纤维菌。它被认为是早产和随后新生儿败血症的病因。本病例报告表明,二氧化碳嗜纤维菌感染的发生率很可能被低估,而且可能有更多未被检测到的二氧化碳嗜纤维菌感染导致了早产和流产。因此,需要更多研究来调查传播途径。

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本文引用的文献

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9

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