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引起菌血症的菌株的系统发育与临床结局或治疗效果无关。

Phylogeny of Strains Responsible for Bacteremia Is Not Associated with Clinical Outcomes or Therapeutic Efficacy.

作者信息

Cabrol Matthieu, Rammaert Blandine, Plouzeau Chloé, Burucoa Christophe, Pichon Maxime

机构信息

Département des Agents Infectieux, Laboratoire de Bactériologie, CHU de Poitiers, 86021 Poitiers, France.

Service de Maladies Infectieuses et Tropicales, CHU de Poitiers, 86021 Poitiers, France.

出版信息

Diseases. 2021 Mar 25;9(2):24. doi: 10.3390/diseases9020024.

Abstract

is a Gram-positive rod, isolated in 2007 in blood culture. Fewer than 15 infections have been reported. Herein, we present a lethal case of bacteremia due to identified through phylogenetic analyses. A woman was found unconscious in a context of chronic diarrhea. An abdominal abscess with a hydroaeric level was discovered, associated with sigmoid adenocarcinoma and peritoneal carcinomatosis. Despite hospitalization in an ICU and the adaptation of antibiotic therapy, the patient died. Blood cultures were positive in the final stage of the disease (>60 h). Identification of was performed using 16S rDNA sequencing. Phylogenetic analyses did not enable classification of these strains according to clinical outcome or the antibiotic sensitivity to treatment. In this case, bacteria were difficult to isolate and MALDI-TOF remained non-contributive. As strains are resistant to probabilistic treatments, addition of metronidazole or vancomycin could optimize clinical management, highlighting the benefit of rapid molecular identification by sequencing.

摘要

是一种革兰氏阳性杆菌,于2007年在血培养中分离出来。报告的感染病例少于15例。在此,我们报告一例经系统发育分析鉴定的因 导致的致死性菌血症病例。一名女性在慢性腹泻的情况下被发现昏迷。发现一个有液气平面的腹部脓肿,与乙状结肠癌和腹膜癌转移有关。尽管在重症监护病房住院并调整了抗生素治疗,但患者仍死亡。在疾病的最后阶段(>60小时)血培养呈阳性。使用16S rDNA测序对 进行鉴定。系统发育分析无法根据临床结果或治疗的抗生素敏感性对这些菌株进行分类。在这种情况下,细菌难以分离,基质辅助激光解吸电离飞行时间质谱(MALDI-TOF)仍然没有帮助。由于菌株对经验性治疗耐药,添加甲硝唑或万古霉素可能会优化临床管理,突出了通过测序进行快速分子鉴定的益处。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/da26/8103246/79fc774ab67f/diseases-09-00024-g001.jpg

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