Spiegelhauer Malene Roed, Yusibova Melodi, Rasmussen Ida Kirstine Bull, Fuglsang Kristian Asp, Thomsen Kim, Andersen Leif Percival
Department of Clinical Microbiology, Copenhagen University Hospital (Rigshospitalet), Henrik Harpestrengs Vej, Copenhagen 2100, Denmark.
Department of Gastroenterology and Hepatology, Copenhagen University Hospital (Rigshospitalet), Blegdamsvej 9, 2100 Copenhagen 2100, Denmark.
Access Microbiol. 2020 Mar 26;2(5):acmi000119. doi: 10.1099/acmi.0.000119. eCollection 2020.
is a Gram-positive coccus and a commensal bacterium of the human gastrointestinal tract with a potential to cause invasive infections. We report the presence of in the blood of a 25-year-old male patient with Crohn's disease, short bowel syndrome treated with home parenteral nutrition, and a history of recurrent bloodstream infections, admitted to our hospital with fever and malaise. A polymicrobial culture of and was identified from blood, for which treatment with meropenem and metronidazole was initiated. The literature was searched for previous cases of infection with . In total, 14 reports describing infection of 28 patients were found, most cases presenting with bacteremia. The previous reports have described variable susceptibility to antibiotics; however, all were reported to be vancomycin resistant. Because of its similarities to other vancomycin-resistant cocci, isolates of might be difficult to identify with traditional methods. Infection may be facilitated by its natural vancomycin resistance, leading to severe infection in hosts with underlying diseases. We describe the treatment of previous cases of infection and suggest treatment methods shown effective in other cases. Vancomycin is often used as treatment of infection with Gram-positive organisms, but this may need to be reevaluated, as several pathogenic bacteria are intrinsically vancomycin resistant. A review on reported treatments of bacteremia by suggests the use of daptomycin, amoxicillin-clavulanate or piperacillin/tazobactam as recommendable antibiotic regimens.
是一种革兰氏阳性球菌,是人类胃肠道的共生细菌,有引发侵袭性感染的可能。我们报告了一名25岁男性克罗恩病患者血液中存在该菌,该患者患有短肠综合征,接受家庭肠外营养治疗,有反复血流感染史,因发热和不适入住我院。从血液中鉴定出该菌与其他细菌的混合培养物,并开始用美罗培南和甲硝唑进行治疗。检索文献以查找先前感染该菌的病例。总共发现了14篇描述28例患者感染情况的报告,大多数病例表现为菌血症。先前的报告描述了对不同抗生素的敏感性;然而,所有报告均显示对万古霉素耐药。由于其与其他耐万古霉素球菌相似,该菌的分离株可能难以用传统方法鉴定。其天然的万古霉素耐药性可能会促进感染,导致患有基础疾病的宿主发生严重感染。我们描述了先前感染病例的治疗方法,并建议采用在其他病例中显示有效的治疗方法。万古霉素常被用作革兰氏阳性菌感染的治疗药物,但这可能需要重新评估,因为几种病原菌本身就对万古霉素耐药。一篇关于该菌所致菌血症报告治疗方法的综述表明,使用达托霉素、阿莫西林 - 克拉维酸或哌拉西林/他唑巴坦作为推荐的抗生素治疗方案。