Hussain Cory, Ball Matthew K, McGwire Bradford S
Division of Infectious Diseases, Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
Department of Pathology, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
Am J Case Rep. 2019 Mar 1;20:268-273. doi: 10.12659/AJCR.913472.
BACKGROUND The overuse of antibiotics in animals promotes the development of multidrug-resistance predisposing for severe polymicrobial human infections. CASE REPORT We describe a case of spontaneous clostridial myonecrosis due to ulcerative colonic infection with multidrug-resistant Salmonella enterica subsp. enterica, serotype 4,[5],12: i: -. Serotyping of the colonic Salmonella isolate in the index case and the bovine farm outbreak isolates from where the patient worked indicated they were both serotype I 4,[5],12: i: -, which is linked with a multitude of large reported disease outbreaks. Further analysis revealed that they are highly genetically related and antibiotic susceptibility testing indicated that they are phenotypically identical. CONCLUSIONS Enteritis due to human acquisition of multidrug-resistant Salmonella from cattle led to the invasion and dissemination of Clostridium septicum resulting in devastating myonecrotic disease. This highlights the ramifications of co-existence and evolution of pathogenic bacteria in animals and humans and lends support to reducing the use of antibiotics in animals.
动物中抗生素的过度使用促进了多重耐药性的发展，这易引发严重的多微生物人类感染。病例报告：我们描述了一例因耐多药肠炎沙门氏菌亚种肠道感染导致溃疡性结肠感染而引发的自发性梭菌性肌坏死病例，该亚种血清型为4,[5],12:i: - 。首例病例的结肠沙门氏菌分离株与患者工作的奶牛场爆发疫情中的分离株血清型鉴定表明，它们均为血清型I 4,[5],12:i: - ，这与大量已报道的疾病爆发有关。进一步分析显示它们具有高度的遗传相关性，抗生素敏感性测试表明它们在表型上相同。结论：人类从牛身上感染耐多药沙门氏菌导致肠炎，进而引发败血梭菌的侵袭和传播，导致毁灭性的肌坏死疾病。这凸显了动物和人类中病原菌共存和进化的影响，并支持减少动物抗生素的使用。
