Division of Infectious Diseases, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-ku, Nagoya, Aichi, 464-8681, Japan.
Department of Infectious Diseases, Nagoya University Hospital, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8550, Japan.
J Infect Chemother. 2022 Oct;28(10):1419-1423. doi: 10.1016/j.jiac.2022.06.005. Epub 2022 Jun 16.
Sphingobacterium is an aerobic, glucose non-fermenting, Gram-negative rod bacterium that has been isolated from soil, plants, food, and water sources, including in hospitals. Reports of systemic infections caused by Sphingobacterium multivorum (S. multivorum) are rare, and their clinical and microbiological characteristics remain unclear. Moreover, conventional microbiological methods have limited ability to identify S. multivorum. We report the first case of obstructive cholangitis with bacteremia caused by S. multivorum in a patient with gastric cancer.
A 68-year-old woman with advanced gastric cancer, hypertension, and hyperlipidemia was admitted with obstructive jaundice, and subsequently developed obstructive cholangitis during the hospital stay. S. multivorum were identified by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry and 16S ribosomal RNA sequencing of the patient's blood samples. Based on the antibiotic susceptibility results of the isolates, cefepime was administered intravenously for 14 days, with good therapeutic outcomes.
S. multivorum infection is rare, and its microbiology and pathogenicity in humans is mostly unknown. Therefore, multiple diagnostic approaches should be used to identify S. multivorum, and antimicrobial therapy should be selected based on the in vitro susceptibility. This report provides clinicians with novel information on the clinical manifestations and diagnostic methods for an accurate diagnosis of S. multivorum.
鞘氨醇单胞菌是一种需氧、葡萄糖非发酵、革兰氏阴性杆菌，已从土壤、植物、食物和水源（包括医院）中分离出来。由鞘氨醇单胞菌（S. multivorum）引起的全身感染报告很少，其临床和微生物学特征尚不清楚。此外，常规微生物学方法识别 S. multivorum 的能力有限。我们报告了首例胃癌患者由鞘氨醇单胞菌引起的阻塞性胆管炎伴菌血症。
一名 68 岁女性，患有晚期胃癌、高血压和高血脂症，因阻塞性黄疸入院，随后在住院期间发生阻塞性胆管炎。通过对患者血液样本的基质辅助激光解吸/电离飞行时间质谱和 16S 核糖体 RNA 测序鉴定出鞘氨醇单胞菌。根据分离株的药敏结果，静脉注射头孢吡肟 14 天，治疗效果良好。
鞘氨醇单胞菌感染罕见，其微生物学和对人类的致病性大多未知。因此，应采用多种诊断方法来识别鞘氨醇单胞菌，并根据体外药敏试验选择抗菌治疗。本报告为临床医生提供了有关鞘氨醇单胞菌准确诊断的临床表现和诊断方法的新信息。
