Kurimoto Tomonori, Cho Yoshiaki, Matsuoka Takashi
Department of Pediatrics, Okinawa Prefectural Nanbu Medical Center and Children's Medical Center, Okinawa, 901-1193, Japan.
Int Med Case Rep J. 2022 May 3;15:231-234. doi: 10.2147/IMCRJ.S361505. eCollection 2022.
, a common component of the skin and mucosal microbiota of both immunocompetent and immunocompromised individuals, has become an emerging pathogen, colonizing indwelling medical devices and causing infections at multiple sites. A 3-year-old boy with an Ommaya reservoir in the right ventricle and a medical history of grade 3 intraventricular hemorrhage, Hirschsprung disease, catheter-related methicillin-resistant bacteremia, and congenital central hypoventilation syndrome was hospitalized for Ommaya reservoir infection with . He was treated with ampicillin, to which the initial isolate was susceptible. may have acquired multiple-drug resistance during the antibiotic treatment due to biofilm production. The Ommaya reservoir was replaced by external ventricular drainage. Cultures of the removed Ommaya reservoir, and cerebrospinal fluid samples grew , which was susceptible to meropenem and vancomycin and resistant to other antibiotics. The antibiotic was switched to vancomycin to treat this new multidrug-resistant strain. After 8 days of vancomycin treatment, the cerebrospinal fluid culture obtained by a lumbar puncture was negative for . In cases of device-associated infections caused by biofilm-producing bacteria, it is desirable to remove the device as soon as possible.
作为免疫功能正常和免疫功能低下个体皮肤及黏膜微生物群的常见组成部分，已成为一种新兴病原体，可定植于植入式医疗器械并在多个部位引发感染。一名3岁男孩，右心室有一个奥马亚贮液器，有3级脑室内出血、先天性巨结肠、导管相关耐甲氧西林菌血症和先天性中枢性通气不足综合征病史，因奥马亚贮液器感染 住院。他接受了氨苄西林治疗，初始分离株对该药敏感。 可能因生物膜形成在抗生素治疗期间获得了多重耐药性。奥马亚贮液器被外置脑室引流管取代。取出的奥马亚贮液器培养物以及脑脊液样本培养出 ，该菌对美罗培南和万古霉素敏感，对其他抗生素耐药。抗生素更换为万古霉素以治疗这种新的多重耐药菌株。万古霉素治疗8天后，腰椎穿刺获取的脑脊液培养物 呈阴性。在由产生物膜细菌引起的器械相关感染病例中，最好尽快移除器械。
