Lee Jaehyeon, Hwang Joo-Hee, Jo Dae Sun, Lee Hye Soo, Hwang Jeong-Hwan
Department of Laboratory Medicine, Chonbuk National University Hospital.
Research Institute of Clinical Medicine of Chonbuk National University.
Jpn J Infect Dis. 2019 May 23;72(3):142-148. doi: 10.7883/yoken.JJID.2018.375. Epub 2018 Nov 30.
To assess the clinical characteristics of the rare Kluyvera ascorbata infection, we reviewed the medical records of patients from whom K. ascorbata was isolated from 2010 to 2016, and conducted a systematic review of the English and Spanish literature in PubMed for reports of K. ascorbata infection in humans from 1971 to 2018. A total of 43 cases (24 adults and 19 children) were enrolled: 3 at our hospital and 40 from the literature review. The urinary tract was the most common site of infection (44.2%, 19/43), followed by the bloodstream (27.9%, 12/43). There was no significant difference in the frequency of urinary tract infections (50% vs 36.8%; P = 0.388) and bloodstream infections (25% vs 31.6%; P = 0.633) in adults and children. Seventeen (60.7%, present in 28 of 43 cases) had nosocomial or healthcare-associated infections: 72.7% among children and 60% among adults. Superinfection developed in 20% (6 in 30 cases). The overall mortality was 12.1%. The antimicrobial agents mainly used in these 43 cases were third-generation cephalosporin, cefepime, piperacillin-tazobactam, ciprofloxacin, amikacin, and carbapenem. Most strains were resistant to ampicillin and first- and second-generation cephalosporins. K. ascorbata is a rare but significant clinical pathogen in adults and children.
为评估罕见的抗坏血酸克吕沃菌感染的临床特征，我们回顾了2010年至2016年间分离出抗坏血酸克吕沃菌的患者的病历，并对PubMed中1971年至2018年间关于人类抗坏血酸克吕沃菌感染报告的英文和西班牙文文献进行了系统综述。共纳入43例病例（24例成人和19例儿童）：3例来自我们医院，40例来自文献综述。泌尿系统是最常见的感染部位（44.2%，19/43），其次是血流（27.9%，12/43）。成人和儿童的泌尿系统感染频率（50%对36.8%；P = 0.388）和血流感染频率（25%对31.6%；P = 0.633）无显著差异。17例（60.7%，43例中有28例存在）发生了医院感染或医疗相关感染：儿童中占72.7%，成人中占60%。20%（30例中有6例）发生了二重感染。总死亡率为12.1%。这43例病例中主要使用的抗菌药物为第三代头孢菌素、头孢吡肟、哌拉西林-他唑巴坦、环丙沙星、阿米卡星和碳青霉烯类。大多数菌株对氨苄西林以及第一代和第二代头孢菌素耐药。抗坏血酸克吕沃菌在成人和儿童中是一种罕见但重要的临床病原体。
