Okazaki Rumi, Hagiwara Shuichi, Kimura Takao, Tokue Yutaka, Kambe Masahiko, Murata Masato, Aoki Makoto, Kaneko Minoru, Oshima Kiyohiro, Murakami Masami
Clinical Laboratory Center Gunma University Hospital Maebashi Gunma Japan.
Department of Emergency Medicine Gunma University Graduate School of Medicine Maebashi Gunma Japan.
Acute Med Surg. 2015 Apr 27;3(1):32-35. doi: 10.1002/ams2.120. eCollection 2016 Jan.
A 92-year-old female resident at a nursing home was transported to the emergency department unconscious, hypotensive, and febrile. Chest X-rays and computed tomography revealed a permeation shadow in the right lung. The patient was diagnosed with sepsis due to pneumonia. At the time of admission, she had not received antibiotics or treatment using medical devices over the past 6 months. Two sets of samples were taken for blood and sputum cultures, and was isolated from all cultures. The strain was identified as metallo-β-lactamase-producing , and the patient was successfully treated with tazobactam-piperacillin. This case indicates that metallo-β-lactamase-producing infection occurred in a non-hospital environment.
After tazobactam-piperacillin treatment, the patient was transferred to another hospital.
Emergency physicians should be aware of multidrug-resistant bacterial infection even in a non-hospital setting.
一名92岁的养老院女性居民被送往急诊科，当时处于昏迷、低血压和发热状态。胸部X光片和计算机断层扫描显示右肺有浸润阴影。该患者被诊断为肺炎导致的败血症。入院时，她在过去6个月内未接受过抗生素治疗或使用过医疗设备。采集了两组血液和痰液样本进行培养，所有培养物中均分离出[具体细菌名称未给出]。该菌株被鉴定为产金属β-内酰胺酶的[具体细菌名称未给出]，患者使用他唑巴坦-哌拉西林成功治疗。该病例表明产金属β-内酰胺酶的[具体细菌名称未给出]感染发生在非医院环境中。
经过他唑巴坦-哌拉西林治疗后，患者被转至另一家医院。
急诊医生即使在非医院环境中也应意识到多重耐药细菌感染。
