Palacio Rosario, Cabezas Laura, Cornejo Cecilia, Seija Verónica
Hospital de Clínicas, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay.
Rev Chilena Infectol. 2020 Apr;37(2):182-185. doi: 10.4067/s0716-10182020000200182.
Comamonas kerstersii is a non-fermenting Gram-negative bacillus. It has been associated with intra-abdominal infections. We describe a clinical case of bacteremia caused by C. kerstersii in a young man with acute appendicitis. The first identification, using the Vitek2 compact system (BioMerieux) from blood cultures, was Comamonas testosteroni. However, using MALDI-TOF was identified as C. kerstersii. The patient was treated first with ampicillin sulbactam and then piperacillin tazobactam with favorable evolution. Within the genus Comamonas, C. testosteroni has been the most frequently reported species as a cause of infections in humans, only 23 cases of C. kerstersii being described. Given the problems of phenotypic identification of these microorganisms, it is possible that some C. testosteroni reports could have corresponded to C. kerstersii. This case highlights the pathogenic role of C. kerstersii and the importance of using MALDI-TOF as a diagnostic tool for non-fermenting Gram-negative bacilli identification.
克氏丛毛单胞菌是一种非发酵革兰氏阴性杆菌。它与腹腔内感染有关。我们描述了一例年轻男性急性阑尾炎患者由克氏丛毛单胞菌引起菌血症的临床病例。最初使用Vitek2 compact系统(生物梅里埃公司)从血培养物中鉴定为睾丸酮丛毛单胞菌。然而,使用基质辅助激光解吸电离飞行时间质谱(MALDI-TOF)鉴定为克氏丛毛单胞菌。患者首先接受氨苄西林舒巴坦治疗,然后使用哌拉西林他唑巴坦,病情好转。在丛毛单胞菌属中,睾丸酮丛毛单胞菌是人类感染最常报道的菌种,仅有23例克氏丛毛单胞菌感染病例被描述。鉴于这些微生物表型鉴定存在的问题,一些睾丸酮丛毛单胞菌的报道可能实际上是克氏丛毛单胞菌。该病例突出了克氏丛毛单胞菌的致病作用以及使用MALDI-TOF作为非发酵革兰氏阴性杆菌鉴定诊断工具的重要性。