Moseley Jack E, Thind Sharanjeet K
Oklahoma Department of Veterans Affairs, Medical Director-Sulphur Center, 344 E Fairlane Avenue Sulphur, Oklahoma City 73086, OK, USA.
Section of Infectious Diseases, Medical Service, Oklahoma City VA Medical Center, Department of Medicine, Oklahoma University Health Sciences Center, 921 NE 13th Street, Oklahoma City 73104, OK, USA.
Case Rep Infect Dis. 2020 Dec 31;2020:8878069. doi: 10.1155/2020/8878069. eCollection 2020.
. is a rapidly growing nontuberculosis mycobacterium (NTM) that was first isolated from soil in 1972 and is ubiquitous in soil, water, and dust. The first reported case of human infection by was published in 1988, presenting as a Hickman catheter-related bacteremia in a patient with ovarian cancer. has since been recognized as a source of predominantly opportunistic bloodstream infections in immunocompromised hosts. We report the case of an adult diabetic male with bloodstream infection secondary to an infected venous-access port that had been implanted nearly six years prior for temporary chemotherapy. . A 66-year-old male with schizophrenia, type 2 diabetes mellitus, and a history of excision and chemotherapy to treat adenocarcinoma of the colon 6 years prior, presented with fever and behavioral changes. He was found to have a bloodstream infection secondary to his implanted subclavian port. Multiple preoperative blood cultures, as well as the removed catheter tip culture, were positive for . The patient's condition improved to near premorbid levels after port removal and 6 weeks of targeted antimicrobial therapy. . Bloodstream infections due to rapidly growing NTM, such as , have been infrequently reported; however, improved isolation and identification techniques based on genomic testing are resulting in a more in-depth recognition of these widely scattered environmental microbes in human infections. Nonetheless, lengthy identification and susceptibility processes remain a diagnostic and treatment barrier. Patients such as ours who have a history of malignancy and an indwelling foreign body have most often been reported as acquiring bacteremia. Fortunately, device removal and appropriate antimicrobial therapy guided by susceptibility data is often enough to manage these atypical mycobacterial infections.
某某菌是一种快速生长的非结核分枝杆菌（NTM），于1972年首次从土壤中分离出来，在土壤、水和灰尘中普遍存在。首例由某某菌引起的人类感染病例于1988年发表，表现为一名卵巢癌患者发生的与希克曼导管相关的菌血症。此后，某某菌被认为是免疫功能低下宿主中主要机会性血流感染的来源。我们报告了一例成年糖尿病男性病例，其因近六年前植入用于临时化疗的静脉通路端口感染而继发某某菌血流感染。一名66岁男性，患有精神分裂症、2型糖尿病，6年前有结肠癌切除及化疗史，出现发热和行为改变。发现他因植入的锁骨下端口继发某某菌血流感染。多次术前血培养以及取出的导管尖端培养，某某菌均呈阳性。在移除端口并进行6周的针对性抗菌治疗后，患者的病情改善至接近病前水平。由快速生长的非结核分枝杆菌如某某菌引起的血流感染鲜有报道；然而，基于基因组检测的改进的分离和鉴定技术正在使人们对这些广泛分布于环境中的微生物在人类感染中的情况有更深入的认识。尽管如此，漫长的鉴定和药敏过程仍然是诊断和治疗的障碍。像我们的患者这样有恶性肿瘤病史和体内有异物的情况，最常被报道为发生某某菌血症。幸运的是，移除装置并根据药敏数据进行适当的抗菌治疗通常足以控制这些非典型分枝杆菌感染。
