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异基因造血干细胞移植患者的血流感染:病例报告及文献复习

bloodstream infection in an allogeneic hematopoietic stem cell transplantation patient: Case report and review of literature.

作者信息

da Silva Campana Pedro, Martinho Lorena Zaine Matos, Batista Marjorie Vieira, Higashino Hermes, Rizek Camila, Rossi Flavia, Oliveira Fernando Nivaldo, Rocha Vanderson, Costa Silvia Figueiredo

机构信息

Instituto de Infectologia Emilio Ribas, São Paulo, Brazil.

Infectious Diseases Division of Hospital das Clinicas of University of São Paulo, São Paulo, Brazil.

出版信息

IDCases. 2020 Feb 27;20:e00724. doi: 10.1016/j.idcr.2020.e00724. eCollection 2020.

Abstract

We report a case of bloodstream infection caused by in a woman with acute myeloid leukemia, 37-years-old, who received an allogeneic hematopoietic stem cell transplant. She developed cutaneous and gastrointestinal tract graft versus host disease, respectively on day 29 and day 69. On day 157 she developed to acute severe respiratory failure. sp was identified by MALDI-TOF and 16S rRNA sequencing from blood culture as . The patient was a nurse that lived in urban areas, and stated no recent trips to countryside areas neither contacted with animals. Despite of the treatment with antibiotics with action against such as linezolid and meropenem the patient evolved to multiorgan dysfunction and death. Our case-report emphasizes the importance of early diagnosis and the use of 16S rRNA sequencing to confirmed the identification of species of infection.

摘要

我们报告了一例37岁急性髓系白血病女性患者在接受异基因造血干细胞移植后发生血流感染的病例。她分别在第29天和第69天出现皮肤和胃肠道移植物抗宿主病。在第157天,她发展为急性严重呼吸衰竭。通过基质辅助激光解吸电离飞行时间质谱(MALDI-TOF)和血培养的16S rRNA测序从血液中鉴定出该病原体为[具体病原体名称未给出]。该患者是一名居住在城市地区的护士,称近期未去过农村地区,也未接触过动物。尽管使用了针对[具体病原体名称未给出]的抗生素如利奈唑胺和美罗培南进行治疗,患者仍发展为多器官功能障碍并死亡。我们的病例报告强调了早期诊断以及使用16S rRNA测序来确认[具体病原体名称未给出]感染菌种鉴定的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6855/7057186/3aa53950ee09/gr1.jpg

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