日本ST8/SCCIV1社区获得性耐甲氧西林感染致死病例。
Fatal case of ST8/SCCIVl community-associated methicillin-resistant infection in Japan.
作者信息
Ishitobi N, Wan T-W, Khokhlova O E, Teng L-J, Yamamori Y, Yamamoto T
机构信息
Department of Critical Care and Emergency Medicine, Shimane Prefectural Central Hospital, Shimane, Japan.
Department of Epidemiology, Genomics and Evolution, International Medical Education and Research Center, Niigata, Japan.
出版信息
New Microbes New Infect. 2018 Aug 11;26:30-36. doi: 10.1016/j.nmni.2018.08.004. eCollection 2018 Nov.
Community-associated methicillin-resistant (CA-MRSA) with ST8/SCCIV threatens human health. However, its pathogenesis remains unclear. ST8 CA-MRSA (CA-MRSA/J) with SCCIVl, which carries the large LPXTG-motif-containing putative adhesin gene, has emerged in Japan. We present the first reported case of death from CA-MRSA/J. The patient was a 64-year-old woman with iliopsoas abscesses complicated by septic pulmonary embolism and multiorgan abscesses. Vancomycin, arbekacin, daptomycin and rifampicin were ineffective. CA-MRSA/J was resistant to erythromycin, clindamycin and antiseptics and was invasive in a HEp-2 cell assay, in contrast to skin-derived villous-adherent CA-MRSA/J. This suggests the strongly invasive pathotype of CA-MRSA/J.
具有ST8/SCCIV的社区获得性耐甲氧西林金黄色葡萄球菌（CA-MRSA）威胁着人类健康。然而，其发病机制仍不清楚。携带含大型LPXTG基序的假定粘附素基因的具有SCCIV1的ST8 CA-MRSA（CA-MRSA/J）已在日本出现。我们报告了首例由CA-MRSA/J导致死亡的病例。患者为一名64岁女性，患有髂腰肌脓肿，并伴有脓毒性肺栓塞和多器官脓肿。万古霉素、阿贝卡星、达托霉素和利福平治疗均无效。与皮肤来源的绒毛粘附性CA-MRSA/J相比，CA-MRSA/J对红霉素、克林霉素和防腐剂耐药，并且在HEp-2细胞试验中具有侵袭性。这表明CA-MRSA/J具有很强的侵袭性病理类型。
Zotero 插件