Department of Pathology & Immunology, Division of Laboratory and Genomic Medicine, Washington University School of Medicine, St. Louis, Missouri, USA
Department of Pathology & Immunology, Division of Laboratory and Genomic Medicine, Washington University School of Medicine, St. Louis, Missouri, USA.
J Clin Microbiol. 2018 Feb 22;56(3). doi: 10.1128/JCM.01788-17. Print 2018 Mar.
The veterinary pathogens in the group (SIG) are increasingly recognized as causes of human infection. Shared features between SIG and may result in the misidentification of SIG in human clinical cultures. This study examined the clinical and microbiological characteristics of isolates recovered at a tertiary-care academic medical center. From 2013 to 2015, 81 SIG isolates were recovered from 62 patients. Patients were commonly ≥50 years old, diabetic, and/or immunocompromised. Documentation of dog exposure in the electronic medical record was not common. Of the 81 SIG isolates, common sites of isolation included 37 (46%) isolates from wound cultures and 17 (21%) isolates from respiratory specimens. Although less common, 10 (12%) bloodstream infections were documented in 7 unique patients. The majority of SIG (65%) isolates were obtained from polymicrobial cultures. In comparison to isolates from the same time period, significant differences were noted in proportion of SIG isolates that were susceptible to doxycycline (74% versus 97%, respectively; < 0.001), trimethoprim-sulfamethoxazole (65% versus 97%, respectively; < 0.001), and ciprofloxacin (78% versus 59%, respectively; < 0.01). Methicillin resistance (MR) was detected in 12 (15%) of 81 SIG isolates. All MR isolates detected by an oxacillin disk diffusion test would have been misclassified as methicillin susceptible using a cefoxitin disk diffusion test. Thus, SIG is recovered from human clinical specimens, and distinction of SIG from is critical for the accurate characterization of MR status in these isolates.
该兽医病原体组(SIG)日益被认为是人类感染的原因。SIG 和 之间的共同特征可能导致人类临床培养物中 SIG 的错误鉴定。本研究检查了在三级保健学术医疗中心回收的分离物的临床和微生物学特征。2013 年至 2015 年,从 62 名患者中回收了 81 株 SIG 分离株。患者通常年龄≥50 岁,患有糖尿病和/或免疫功能低下。电子病历中未常见记录狗暴露情况。在 81 株 SIG 分离株中,常见的分离部位包括 37 株(46%)来自伤口培养物和 17 株(21%)来自呼吸道标本。尽管较少见,但在 7 名独特的患者中记录了 10 例(12%)菌血症。大多数 SIG(65%)分离株来自混合培养物。与同一时期的 分离株相比,SIG 分离株对多西环素(分别为 74%和 97%;<0.001)、甲氧苄啶-磺胺甲恶唑(分别为 65%和 97%;<0.001)和环丙沙星(分别为 78%和 59%;<0.01)的敏感性存在显著差异。在 81 株 SIG 分离株中检测到 12 株(15%)耐甲氧西林。通过苯唑西林纸片扩散试验检测到的所有耐甲氧西林分离株,如果使用头孢西丁纸片扩散试验,将被错误分类为甲氧西林敏感。因此,SIG 从人类临床标本中回收,区分 SIG 和 对于准确描述这些分离株的耐甲氧西林状态至关重要。