Ochi Fumihiro, Tauchi Hisamichi, Moritani Kyoko, Murakami Shinobu, Miyamoto Hitoshi, Ueda Mayo, Nagai Kozo, Eguchi-Ishimae Minenori, Eguchi Mariko
Department of Pediatrics, Ehime University Graduate School of Medicine, Toon, Ehime 791-0295, Japan.
Clinical Laboratory Division, Ehime University Hospital, Toon, Ehime 791-0295, Japan.
Case Rep Pediatr. 2021 Apr 9;2021:6691569. doi: 10.1155/2021/6691569. eCollection 2021.
The most common organisms isolated from pediatric catheter-related bloodstream infections (CRBSIs) are Gram-positive cocci, such as coagulase-negative staphylococci and . There are few formal reports of infection and even fewer reports of CRBSI due to this Gram-positive rod. Here we report the first case of CRBSI due to in an 8-year-old girl with acute myeloid leukemia in Japan. The isolate exhibited decreased susceptibility to -lactam antibiotics. Antimicrobial therapy with meropenem and vancomycin, in addition to the removal of central venous catheter line, consequently led to a significant clinical improvement of the patient's symptoms. A literature review found available clinical courses in 16 cases (4 pediatric cases including our case) of infection. Our case and those in literature suggested that infection often occurs in patients with indwelling central venous catheters; the literature review further suggested that removal of central venous catheters is required in most cases. Special attention should be paid to the detection of opportunistic infections due to spp. in immunocompromized children who are using a central venous catheter.
从儿科导管相关血流感染（CRBSIs）中分离出的最常见微生物是革兰氏阳性球菌，如凝固酶阴性葡萄球菌等。关于该菌感染的正式报告很少，因这种革兰氏阳性杆菌导致CRBSI的报告更少。在此，我们报告日本首例8岁急性髓系白血病女童因该菌导致的CRBSI。分离出的菌株对β-内酰胺类抗生素敏感性降低。除拔除中心静脉导管外，美罗培南和万古霉素抗菌治疗使患者症状显著改善。文献回顾发现了16例该菌感染（包括我们的病例在内有4例儿科病例）的可用临床病程。我们的病例及文献中的病例表明，该菌感染常发生于留置中心静脉导管的患者；文献回顾进一步表明，大多数情况下需要拔除中心静脉导管。对于使用中心静脉导管的免疫功能低下儿童，应特别注意检测由该菌属引起的机会性感染。
