Gren Caroline, Spiegelhauer Malene Roed, Rotbain Emelie Curovic, Ehmsen Boje Kvorning, Kampmann Peter, Andersen Leif Percival
Department of Clinical Microbiology, Rigshospitalet, Copenhagen, Denmark.
Department of Hematology, Rigshospitalet, Copenhagen, Denmark.
Access Microbiol. 2019 Aug 7;1(8):e000048. doi: 10.1099/acmi.0.000048. eCollection 2019.
We present a case of sepsis in a woman suffering from multiple myeloma and myelodysplastic syndrome. , a Gram-positive coccus and a gut commensal, has been described in nine cases of infection in the literature, with most infections having occurred in patients with either gastrointestinal symptoms or prosthesis infections. In this case, was identified by mass spectrometry, and showed susceptibility to penicillin, meropenem, tetracycline, metronidazole and clindamycin. The patient was successfully treated initially with intravenous piperacillin/tazobactam and metronidazole, and then switched to oral penicillin and metronidazole. The cause of infection is hypothesized to have been a shift in the gut microbiota towards an excess growth of caused by immunosuppression, and bacterial translocation across a vulnerable mucosal barrier due to prednisolone treatment and severe thrombocytopenia.
我们报告了一例患有多发性骨髓瘤和骨髓增生异常综合征的女性败血症病例。文献中已描述了9例感染病例,其中一种革兰氏阳性球菌是肠道共生菌,大多数感染发生在有胃肠道症状或假体感染的患者中。在该病例中,通过质谱法鉴定出该菌,其对青霉素、美罗培南、四环素、甲硝唑和克林霉素敏感。患者最初成功接受了静脉注射哌拉西林/他唑巴坦和甲硝唑治疗,然后改用口服青霉素和甲硝唑。据推测,感染原因是免疫抑制导致肠道微生物群向该菌过度生长转变,以及泼尼松龙治疗和严重血小板减少导致细菌通过脆弱的黏膜屏障发生移位。