Almasy Emoke, Szederjesi Janos, Rad Paul, Georgescu Anca
Discipline of Intensive Care, University of Medicine and Pharmacy Tîrgu Mureş, Tîrgu Mureş, Romania.
Discipline of Infectious Diseases, University of Medicine and Pharmacy Tîrgu Mureş, Tîrgu Mureş, Romania.
J Crit Care Med (Targu Mures). 2016 Nov 8;2(4):201-204. doi: 10.1515/jccm-2016-0027. eCollection 2016 Oct.
is a rarely isolated non-fermentative, aerobic bacillus, which occasionally causes severe human infections, especially in immunocompromised patients. Strains have been isolated from various clinical and environmental sources.
A 67-year-old man was admitted to the Intensive Care Unit with acute respiratory failure. The patient was diagnosed with bilateral pneumonia, pulmonary sepsis and underwent invasive mechanical ventilation. Examination revealed diminished bilateral vesicular breath sounds, fever, intense yellow tracheal secretions, a respiratory rate of 24/minute, a heart rate of 123/minute, and blood pressure of 75/55 mmHg. Vasoactive treatment was initiated. Investigations revealed elevated lactate and C-reactive protein levels. A chest X-ray showed bilateral infiltration. Parenteral ciprofloxacin and ceftriaxone were administered. Tracheal aspirate culture and blood culture showed bacterial growth of Cupriavidus pauculus. Colistin was added to the treatment. There was a poor clinical response despite repeated blood culture showing negative results. The diagnosis of multiple organ dysfunction syndrome (MODS) caused by C. pauculus was made. The patient died eleven days after admission.
Clinical improvement cannot always be expected in spite of targeted antibiotic therapy. This pathogen should be considered responsible for infections that usually develop in immunocompromised patients.
嗜麦芽窄食单胞菌是一种罕见的非发酵需氧芽孢杆菌，偶尔会引起严重的人类感染，尤其是在免疫功能低下的患者中。已从各种临床和环境来源分离出该菌株。
一名67岁男性因急性呼吸衰竭入住重症监护病房。患者被诊断为双侧肺炎、肺败血症，并接受了有创机械通气。检查发现双侧肺泡呼吸音减弱、发热、气管分泌物呈深黄色、呼吸频率为24次/分钟、心率为123次/分钟、血压为75/55mmHg。开始进行血管活性治疗。检查发现乳酸和C反应蛋白水平升高。胸部X线显示双侧浸润。给予静脉注射环丙沙星和头孢曲松。气管吸出物培养和血培养显示嗜麦芽寡养单胞菌生长。治疗中加用了黏菌素。尽管重复血培养显示阴性结果，但临床反应不佳。诊断为由嗜麦芽寡养单胞菌引起的多器官功能障碍综合征（MODS）。患者入院11天后死亡。
尽管进行了针对性抗生素治疗，但并非总能预期临床症状改善。这种病原体应被视为免疫功能低下患者通常发生感染的病因。
