金黄色葡萄球菌性前列腺脓肿：一例临床病例报告及文献综述
Staphylococcus aureus Prostatic abscess: a clinical case report and a review of the literature.
作者信息
Carroll David E, Marr Ian, Huang G Khai Lin, Holt Deborah C, Tong Steven Y C, Boutlis Craig S
机构信息
Department of Infectious Diseases, Royal Darwin Hospital, Darwin, Northern Territory, Australia.
Daisy Hill Hospital, Southern Health and Social Care Trust, Newry, Northern Ireland, United Kingdom.
出版信息
BMC Infect Dis. 2017 Jul 21;17(1):509. doi: 10.1186/s12879-017-2605-4.
BACKGROUND
Prostatic abscess is a rare complication of acute bacterial prostatitis and is most commonly caused by Enterobacteriaceae. We report on a case of prostatic abscess caused by Staphylococcus aureus and conduct a review of the literature.
CASE PRESENTATIVE
We present a case of S. aureus prostatic abscess that was successfully treated with a combination of antibiotic and surgical therapy. The isolate was non–multidrug-resistant, methicillin-resistant Staphylococcus aureus and was genotyped as clonal complex 5, an emerging regional clone that is trimethoprim resistant and Panton-Valentine leukocidin positive. This current case report is the first to describe the use of clindamycin step-down therapy. A literature review identified a further 39 cases of S. aureus prostatic abscesses, of which 26 were methicillin resistant.
CONCLUSION
S. aureus is an uncommon cause of prostatic abscess. Optimal management includes both antibiotic therapy and surgical drainage. Our use of clindamycin as step-down therapy was guided by its excellent prostatic penetration.
背景
前列腺脓肿是急性细菌性前列腺炎的一种罕见并发症，最常见的病因是肠杆菌科细菌。我们报告一例由金黄色葡萄球菌引起的前列腺脓肿病例，并对相关文献进行综述。
病例介绍
我们呈现一例金黄色葡萄球菌性前列腺脓肿病例，该病例通过抗生素和手术联合治疗成功治愈。分离出的菌株为非多重耐药、耐甲氧西林金黄色葡萄球菌，基因分型为克隆复合体5，这是一种新出现的区域克隆，对甲氧苄啶耐药且Panton-Valentine杀白细胞素呈阳性。本病例报告首次描述了使用克林霉素逐步降级疗法。文献综述又发现了39例金黄色葡萄球菌性前列腺脓肿病例，其中26例耐甲氧西林。
结论
金黄色葡萄球菌是前列腺脓肿的罕见病因。最佳治疗方法包括抗生素治疗和手术引流。我们使用克林霉素作为逐步降级疗法是基于其良好的前列腺穿透性。
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