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造血干细胞移植中嗜二氧化碳噬纤维菌血症感染:两例报告及文献复习

Capnocytophaga sputigena bloodstream infection in hematopoietic stem cell transplantations: two cases report and review of the literature.

作者信息

Mendes Fernanda Rodrigues, Bruniera Felipe Ribeiro, Schmidt Jayir, Cury Ana Paula, Rizeck Camila, Higashino Hermes, Oliveira Fernando Nivaldo, Rossi Flavia, Rocha Vanderson, Costa Silvia Figueiredo

机构信息

Unidade de Transplante de Medula Óssea, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, São Paulo, Brazil.

Laboratório de Microbiologia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, São Paulo, Brazil.

出版信息

Rev Inst Med Trop Sao Paulo. 2020;62:e48. doi: 10.1590/s1678-9946202062048. Epub 2020 Jul 13.

Abstract

Capnocytophaga is a group of facultative anaerobic gram-negative bacteria present in the oral cavity of humans, dogs and cats, as part of their normal oral flora. Here, we described two cases of bloodstream infections (BSI) caused by Capnocytophaga in neutropenic autologous hematopoietic stem cell transplantation (auto-HSCT) patients with mucositis (Grade I and Grade III) identified by Maldi-Tof. They were successfully treated with β-lactam (meropenem and piperacillin-tazobactam). The species C. sputigena was confirmed by 16S rRNA gene sequencing in one patient. The review of literature showed that C. ochraceae was the most frequent species causing BSI in auto-HSCT patients and that the patients usually presented mucositis and were neutropenic at the onset of the infection.

摘要

二氧化碳嗜纤维菌是一组兼性厌氧革兰氏阴性菌,存在于人类、狗和猫的口腔中,是其正常口腔菌群的一部分。在此,我们描述了两例由二氧化碳嗜纤维菌引起的血流感染(BSI)病例,这些病例发生在患有黏膜炎(I级和III级)的中性粒细胞减少的自体造血干细胞移植(auto-HSCT)患者中,通过基质辅助激光解吸电离飞行时间质谱(Maldi-Tof)鉴定。他们通过β-内酰胺类药物(美罗培南和哌拉西林-他唑巴坦)成功治愈。通过16S rRNA基因测序在一名患者中确诊为痰液二氧化碳嗜纤维菌。文献综述表明,赭色二氧化碳嗜纤维菌是auto-HSCT患者中引起BSI最常见的菌种,并且患者通常出现黏膜炎,在感染开始时中性粒细胞减少。

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