Hoashi Kosuke, Harada Sohei, Ishii Yoshikazu, Aoki Kotaro, Ishikawa Shin, Oshiro Yusuke, Shinzato Takashi
Department of Infectious Diseases, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Japan.
Department of Infectious Diseases, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi, 470-1192, Japan.
IDCases. 2019 Jun 14;17:e00577. doi: 10.1016/j.idcr.2019.e00577. eCollection 2019.
Hypervirulent has been associated with community-acquired liver abscesses in relatively healthy subjects since the 1990s, occasionally accompanied by disseminated disease. While isolates of capsular genotype K1 belonging to sequence type (ST) 23 have been the most prominent causative pathogen of this syndrome, other virulent clones have been implicated sporadically in recent years. A 68-year-old woman with diabetes in Okinawa, Japan suffered from a liver abscess, which recurred after a prolonged antibacterial treatment. The clinical course was further complicated with multiple sites of dissemination. Another 45-year-old woman living in Okinawa without underlying conditions was also diagnosed with a community-acquired liver abscess, which was cured with antibacterial treatment alone. Both of the causative isolates carried and aerobactin genes, and were confirmed as capsular genotype K2 and ST375. K2-ST375 is a hypervirulent clone of epidemiological significance causing severe community-acquired infections in relatively healthy subjects. More information about clinical characteristics and molecular epidemiology of hypervirulent clones other than K1-ST23 should be accumulated.
自20世纪90年代以来，高毒力菌株与相对健康人群的社区获得性肝脓肿有关，偶尔伴有播散性疾病。虽然属于序列型（ST）23的荚膜基因型K1分离株一直是该综合征最主要的致病病原体，但近年来其他毒力克隆也偶尔涉及。日本冲绳一名68岁的糖尿病女性患肝脓肿，在长期抗菌治疗后复发。临床病程因多处播散而进一步复杂化。另一名居住在冲绳、无基础疾病的45岁女性也被诊断为社区获得性肝脓肿，仅通过抗菌治疗就治愈了。两种致病分离株都携带气杆菌素基因，被确认为荚膜基因型K2和ST375。K2-ST375是一种具有流行病学意义的高毒力克隆，可在相对健康的人群中引起严重的社区获得性感染。除K1-ST23外，应积累更多关于其他高毒力克隆的临床特征和分子流行病学信息。
