皮炎外瓶霉作为婴儿中心静脉导管相关血流感染的病因：病例报告及文献综述
Exophiala dermatitidis as a cause of central line associated bloodstream infection in an infant: Case report and literature review.
作者信息
Kumar Anil, Nandakumar Aswathy, Nair Sajitha, Singh Ashutosh, Shashindran Nandita, Thulasidharan Swathy, Subhash Kiran, Ramachandran Arya, Chowdhary Anuradha
机构信息
Department of Microbiology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Ponekkara, Kerala, India.
Department of Microbiology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Ponekkara, Kerala, India.
出版信息
Rev Iberoam Micol. 2021 Jan-Mar;38(1):12-15. doi: 10.1016/j.riam.2020.09.004. Epub 2020 Dec 3.
BACKGROUND
Exophiala dermatitidis is a dematiaceous fungus known to cause superficial, subcutaneous, cutaneous and deep seated infections, and rarely central line associated bloodstream infection (CLABSI). A case of CLABSI due to E. dermatitidis in an infant is described.
CASE REPORT
Clinical and laboratory data were extracted from patient's chart and laboratory records. The isolate was identified as E. dermatitidis by phenotypic characterization and sequencing of the ITS and LSU regions of the ribosomal DNA. Medline search was done to review all cases of CLABSI due to E. dermatitidis. Among the azoles tested, posaconazole (0.06mg/l), voriconazole (0.03mg/l) and itraconazole (0.03mg/l) showed very low MICs when compared to fluconazole (4mg/l) CONCLUSIONS: As we did not found in the literature any case of CLABSI due to E. dermatitidis in an infant, we report the first one. Sequencing is a mandatory method for accurately identifying this species. Prompt removal of the central line, followed by a treatment with amphotericin B or an azole, seems to be the most effective treatment.
背景
皮炎外瓶霉是一种暗色真菌，已知可引起浅表、皮下、皮肤及深部感染，很少引起中心静脉导管相关血流感染（CLABSI）。本文描述了1例婴儿因皮炎外瓶霉引起的CLABSI病例。
病例报告
从患者病历和实验室记录中提取临床和实验室数据。通过对核糖体DNA的ITS和LSU区域进行表型鉴定和测序，将分离菌株鉴定为皮炎外瓶霉。通过医学文献检索回顾了所有因皮炎外瓶霉引起的CLABSI病例。在所测试的唑类药物中，泊沙康唑（0.06mg/l）、伏立康唑（0.03mg/l）和伊曲康唑（0.03mg/l）与氟康唑（4mg/l）相比显示出非常低的最低抑菌浓度（MIC）。结论：由于我们在文献中未发现任何婴儿因皮炎外瓶霉引起CLABSI的病例，因此我们报告首例。测序是准确鉴定该菌种的必要方法。及时拔除中心静脉导管，随后用两性霉素B或唑类药物治疗，似乎是最有效的治疗方法。
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