Centro de Excelencia en Estudios Económicos y Sociales en Salud, Universidad San Ignacio de Loyola, Lima, Peru.
Facultad de Ciencias de la Salud, Universidad Peruana de Ciencias Aplicadas, Lima, Peru.
Am J Trop Med Hyg. 2023 Jun 20;109(2):356-367. doi: 10.4269/ajtmh.23-0168. Print 2023 Aug 2.
Cedecea lapagei is a gram-negative, non-encapsulated, facultative anaerobic bacterium that has been reported in only a few cases with varying clinical presentations, drug susceptibility, and treatment since its first isolation in 1981. This study aimed to describe a case report of C. lapagei in Peru and systematically review the documented case reports of individuals infected with C. lapagei. A 59-year-old man who had become bedridden with Parkinson's disease and had epilepsy presented with a 1-week history of fever and sore throat and was admitted. Physical examination revealed an obtundation state and abolished vesicular murmur in the right hemithorax. During hospitalization, the patient was diagnosed with various infections, including tuberculosis, for which he received broad-spectrum antibiotics. In the absence of clinical improvement, a urine culture was performed showing C. lapagei (detected by BD Phoenix M50 system, Vernon Hills, IL). The patient received amoxicillin/clavulanate and was discharged. Case reports of C. lapagei were also searched in five databases on January 28, 2023. Twenty cases of C. lapagei were reported worldwide between 2006 and 2022, 16 of which involved adults. Fever was the most common manifestation (75%), and pneumonia was the primary form of presentation (45%). Moreover, 90% of the patients had at least one comorbidity, and 15% died. Also, most of the isolates were sensitive to ciprofloxacin (81%), meropenem (62%), and amikacin (60%). Overall, C. lapagei should be suspected in compromised hosts, particularly those with pneumonia. Although the bacterium can affect various organs and the antibiotic susceptibility pattern is variable, quinolones, tetracyclines, and carbapenems seem to be the first therapeutic option.
Cedecea lapagei 是一种革兰氏阴性、非囊泡、需氧菌，自 1981 年首次分离以来，仅在少数几种临床表现、药物敏感性和治疗方法各不相同的病例中报道过。本研究旨在描述秘鲁的一例 C. lapagei 病例，并系统回顾已发表的感染 C. lapagei 的个体病例报告。一名 59 岁的帕金森病卧床不起并患有癫痫的男性，因发热和咽痛 1 周入院。体格检查显示意识障碍状态，右半胸音减弱。住院期间，患者被诊断出患有多种感染，包括结核病，为此他接受了广谱抗生素治疗。由于临床症状没有改善，进行了尿液培养，结果显示为 C. lapagei（由 BD Phoenix M50 系统，Vernon Hills，IL 检测到）。患者接受阿莫西林/克拉维酸治疗后出院。2023 年 1 月 28 日，还在五个数据库中搜索了 C. lapagei 的病例报告。2006 年至 2022 年期间，全球报告了 20 例 C. lapagei 病例，其中 16 例涉及成人。发热是最常见的表现（75%），肺炎是主要的表现形式（45%）。此外，90%的患者至少有一种合并症，15%的患者死亡。此外，大多数分离株对环丙沙星（81%）、美罗培南（62%）和阿米卡星（60%）敏感。总体而言，C. lapagei 应在免疫功能低下的宿主中怀疑，特别是那些患有肺炎的宿主。尽管该细菌可影响多种器官，且抗生素敏感性模式各不相同，但喹诺酮类、四环素类和碳青霉烯类似乎是首选的治疗方法。
