Nwaedozie Somto, Mojarrab Javad Najjar, Gopinath Prathima, Fritsche Thomas, Nasser Rana M
Department of Internal Medicine, Marshfield Clinic Health System - Marshfield, Marshfield, WI 54449, USA.
Department of Pathology, Marshfield Clinic Health System - Marshfield, Marshfield, WI 54449, USA.
IDCases. 2022 Jun 23;29:e01548. doi: 10.1016/j.idcr.2022.e01548. eCollection 2022.
Skin commensals, especially gram-positive cocci, are the usual microbial organisms that cause post-operative sternal wound infections. Rarely, environmental bacteria such as spp. have been implicated as etiological agents in post-cardiac procedure surgical site infections. We report a case of a patient who presented with post-coronary artery bypass sternal osteomyelitis caused by this uncommon pathogen, and review relevant medical literature to identify commonalities in presentation, diagnosis and management. Repeat isolation of in the setting of post-procedure wound infection should raise suspicion for a real pathogenicity. Definitive identification requires a broad range of bacterial PCR DNA amplification and sequencing followed by susceptibility testing as treatment may require a prolonged course of antibiotics.
皮肤共生菌，尤其是革兰氏阳性球菌，是导致术后胸骨伤口感染的常见微生物。很少有环境细菌如某些菌种被认为是心脏手术后手术部位感染的病原体。我们报告了一例由这种罕见病原体引起的冠状动脉搭桥术后胸骨骨髓炎患者，并回顾相关医学文献以确定其临床表现、诊断和管理方面的共性。在术后伤口感染的情况下反复分离出该菌应引起对其真正致病性的怀疑。明确鉴定需要进行广泛的细菌PCR DNA扩增和测序，随后进行药敏试验，因为治疗可能需要长时间使用抗生素。
