日本首例对第三代头孢菌素耐药的胆道感染病例报告及文献综述
The first case of third-generation cephalosporins resistant biliary tract infection in Japan: A case report and review of the literature.
作者信息
Mutoh Yoshikazu, Kobe Tomohisa, Hirano Tomoya, Ichihara Toshihiko, Takenaka Hiroyuki, Niinomi Takuro, Umemura Takumi, Kuroiwa Masanori
机构信息
Department of Infectious Diseases, Tosei General Hospital, Seto, Aichi, Japan.
Department of Gastroenterology, Tosei General Hospital, Seto, Aichi, Japan.
出版信息
IDCases. 2019 Jan 29;15:e00498. doi: 10.1016/j.idcr.2019.e00498. eCollection 2019.
INTRODUCTION
is a gram-negative, catalase-positive, oxidase-negative, aerobic fermentative bacterium with flagella. This organism colonizes in the human body and its pathogenicity is extremely low; few clinical cases of infection have been reported.
PRESENTATION OF CASE
We report on a patient who experienced severe sepsis and acute cholangitis due to bacteremia and was treated with levofloxacin following antibiotic susceptibility testing. To our knowledge, this is the first case report of third-generation cephalosporins resistant infection in Japan.
DISCUSSION
Although this pathogen produces innate CTX-M type β-lactamases and is generally resistant to first- and second-generation penicillins and cephalosporins, multi-drug resistant infection, including ceftriaxone resistant infection has seldom been reported.
CONCLUSION
The increase of drug-resistant pathogens is of concern; in such cases, rapid microbial identification and appropriate antibiotic selection are crucial for successful treatment.
引言
是一种革兰氏阴性、过氧化氢酶阳性、氧化酶阴性、有鞭毛的需氧发酵菌。这种微生物在人体中定殖，其致病性极低；很少有感染的临床病例报道。
病例介绍
我们报告了一名因菌血症发生严重脓毒症和急性胆管炎的患者，在进行抗生素敏感性测试后用左氧氟沙星进行了治疗。据我们所知，这是日本首例对第三代头孢菌素耐药感染的病例报告。
讨论
尽管这种病原体产生固有CTX-M型β-内酰胺酶，通常对第一代和第二代青霉素及头孢菌素耐药，但包括对头孢曲松耐药感染在内的多重耐药感染很少被报道。
结论
耐药病原体的增加令人担忧；在这种情况下，快速的微生物鉴定和适当的抗生素选择对于成功治疗至关重要。
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