Tian Xiangyong, Jing Nan, Duan Wenjing, Wu Xiaoqiang, Zhang Chan, Wang Shanmei, Yan Tianzhong
Department of Urology, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Henan University People's Hospital, Zhengzhou, People's Republic of China.
Department of Clinical Microbiology, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Henan University People's Hospital, Zhengzhou, People's Republic of China.
Infect Drug Resist. 2022 Jul 19;15:3841-3845. doi: 10.2147/IDR.S370170. eCollection 2022.
, an emerging opportunistic pathogen, can infect immunocompromised patients but is a rare cause of severe sepsis and septic shock in kidney transplant recipients (KTRs).
We present a case of septic shock after renal transplant in a 41-year-old male, which was finally proven to be caused by through blood cultures and mass spectrometric analysis following the negative result of metagenomic next-generation sequencing (mNGS). He was finally cured after the application of sensitive antibiotics (sulfamethoxazole-trimethoprim, amikacin and piperacillin-tazobactam) based on the drug sensitivity test results. The patient had a satisfactory recovery with no complications during a 6-month follow-up period.
This study highlights that is an easily overlooked cause of septic shock in KTRs requiring a detailed inquiry of medical history with inflammatory markers monitored closely. Traditional blood cultures still should be taken seriously. It also provides a cautionary tale that negative results of mNGS have to be interpreted with caution.
，一种新兴的机会性病原体，可感染免疫功能低下的患者，但在肾移植受者（KTRs）中是严重脓毒症和脓毒性休克的罕见病因。
我们报告一例41岁男性肾移植后发生脓毒性休克的病例，在宏基因组下一代测序（mNGS）结果为阴性后，通过血培养和质谱分析最终证实为由 引起。根据药敏试验结果应用敏感抗生素（磺胺甲恶唑-甲氧苄啶、阿米卡星和哌拉西林-他唑巴坦）后，他最终治愈。在6个月的随访期内，患者恢复良好，无并发症。
本研究强调， 在KTRs中是脓毒性休克一个容易被忽视的病因，需要详细询问病史并密切监测炎症标志物。传统血培养仍应予以重视。它还警示人们，对mNGS的阴性结果必须谨慎解读。
