Department of Infection Control Science, Osaka City University, Graduate School of Medicine, Osaka, Japan.
Department of Bacteriology, Osaka City University, Graduate School of Medicine, Osaka, Japan.
Anaerobe. 2023 Apr;80:102695. doi: 10.1016/j.anaerobe.2023.102695. Epub 2023 Jan 12.
Clostridium ramosum is one of the obligate anaerobes that constitute the intestinal microbiota, and one of the rare Clostridia. With Clostridium ramosum, very few data have been reported to investigate antimicrobial susceptibility for clinical isolates that have caused bacteremia. Here, we report two cases of Clostridium ramosum bacteremia. The first case was a 54-year-old Japanese man with taking 20mg hydrocortisone for hypopituitarism. He presented to the emergency department for an unknown cause cardiopulmonary arrest. At the hospital day 36, he had fever and a drop in blood pressure. Abdomen computed tomography (CT) revealed free air around the ascending colon, we diagnosed with intestinal perforation, and peritonitis. Blood culture revealed Clostridium ramosum. We administered conservative management by 6-week of antibiotic treatment. The second case was a 78-year-old Japanese man with no significant medical history. He was referred to our hospital with fever and abdominal pain. Abdomen CT revealed perforated appendicitis, and blood cultures revealed Clostridium ramosum. We performed emergency surgery, and administered one-week course of antibiotic treatment. This report demonstrates two cases of Clostridium ramosum bacteremia with intestinal perforation, and the antimicrobial susceptibility of each clinical strain. For the future, it is necessary to accumulate data on the susceptibility of clinical isolates in order to find an appropriate treatment.
脆弱拟杆菌是构成肠道微生物群的专性厌氧菌之一，也是罕见的梭菌之一。脆弱拟杆菌很少有关于引起菌血症的临床分离株的药敏数据。在这里，我们报告两例脆弱拟杆菌菌血症。第一例是一名 54 岁的日本男性，因垂体功能减退症服用 20mg 氢化可的松。他因不明原因心肺骤停到急诊就诊。在医院第 36 天，他出现发热和血压下降。腹部 CT 显示升结肠周围有游离气体，我们诊断为肠穿孔和腹膜炎。血培养发现脆弱拟杆菌。我们通过 6 周的抗生素治疗进行保守治疗。第二例是一名 78 岁的日本男性，无明显病史。他因发热和腹痛被转至我院。腹部 CT 显示阑尾穿孔，血培养发现脆弱拟杆菌。我们进行了急诊手术，并给予了一周的抗生素治疗。本报告展示了两例脆弱拟杆菌菌血症合并肠穿孔，以及各临床菌株的药敏性。未来，有必要积累临床分离株药敏数据，以找到合适的治疗方法。
