Siddiqui Tasneem, Patel Sangram Singh, Sinha Richa, Ghoshal Ujjala, Sahu Chinmoy
Department of Microbiology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India.
Access Microbiol. 2022 May 31;4(5):acmi000367. doi: 10.1099/acmi.0.000367. eCollection 2022 Aug.
is a rare opportunistic pathogen capable of causing a serious infection in immunocompromised patients. Our objective was to describe all cases of bloodstream infection identified within 2 years at our tertiary care centre, focusing on clinical characteristics, risk factors, antibiotic sensitivity patterns, management and outcomes.
We compiled a descriptive case series including 14 non-duplicate isolates obtained from bloodstream infection samples from the microbiology laboratory of a tertiary care centre from June 2019 to June 2021. All isolates were initially identified based on their morphological properties and biochemical reactions, and then underwent matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF-MS) examination for confirmation of identity. Antibiotic susceptibility testing was performed using the Kirby-Bauer disc diffusion method and Vitek 2. All 14 patients presented with symptoms of fever and/or chills, and a positive blood culture for . After 48 h of incubation, no growth was reported from any of the current environmental or pharmaceutical water samples. Chemotherapy (9/14), mechanical ventilation (4/14), steroid use (2/14) and diabetes mellitus (1/14) were associated risk factors in our patients. The antibiotic sensitivity panel showed maximum resistance to aminoglycosides (64.3%) and no resistance to cefoperazone/sulbactum. Patients received treatment with cefoperazone/sulbactum and meropenem or ceftazidime. Thirteen patients recovered with antibiotic therapy and one patient succumbed to his illness.
can cause bloodstream infections in immunocompromised patients. It is likely to be missed or underreported due to lack of clinical awareness. MALDI-TOF MS is helpful in rapid identification. is resistant to many routinely used antibiotics, including carbapenems.
是一种罕见的机会性病原菌，能够在免疫功能低下的患者中引起严重感染。我们的目的是描述在我们的三级医疗中心2年内确诊的所有血流感染病例，重点关注临床特征、危险因素、抗生素敏感性模式、治疗及预后。
我们整理了一个描述性病例系列，包括2019年6月至2021年6月从一家三级医疗中心微生物实验室的血流感染样本中获得的14株非重复分离株。所有分离株最初根据其形态学特性和生化反应进行鉴定，然后进行基质辅助激光解吸/电离飞行时间质谱（MALDI-TOF-MS）检测以确认其身份。采用 Kirby-Bauer 纸片扩散法和 Vitek 2 进行抗生素敏感性试验。所有14例患者均出现发热和/或寒战症状，且血培养阳性。培养48小时后，目前的任何环境或制药用水样本均未报告生长情况。化疗（9/14）、机械通气（4/14）、使用类固醇（2/14）和糖尿病（1/14）是我们患者的相关危险因素。抗生素敏感性分析显示对氨基糖苷类耐药率最高（64.3%），对头孢哌酮/舒巴坦无耐药。患者接受头孢哌酮/舒巴坦和美罗培南或头孢他啶治疗。13例患者经抗生素治疗后康复，1例患者因病死亡。
可在免疫功能低下的患者中引起血流感染。由于缺乏临床认识，很可能被漏诊或报告不足。MALDI-TOF MS有助于快速鉴定。对包括碳青霉烯类在内的许多常用抗生素耐药。
