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病例报告:孟加拉国一例因[具体病因未给出]导致的社区获得性尿路感染成功治疗病例。

Case report: A successfully treated case of community-acquired urinary tract infection due to in Bangladesh.

作者信息

Mazumder Razib, Hussain Arif, Bhadra Bithika, Phelan Jody, Campino Susana, Clark Taane G, Mondal Dinesh

机构信息

Laboratory Sciences and Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr, b), Dhaka, Bangladesh.

Department of Biochemistry and Microbiology, North South University, Dhaka, Bangladesh.

出版信息

Front Med (Lausanne). 2023 Jun 26;10:1206756. doi: 10.3389/fmed.2023.1206756. eCollection 2023.

Abstract

, a nosocomial pathogen, is increasingly associated with extensive drug resistance and virulence profiles. It is responsible for high morbidity and mortality. This report describes the first successfully treated case of community-acquired urinary tract infection (UTI) caused by in an elderly housewife with Type-2 diabetes (T2D) from Dhaka, Bangladesh. The patient was empirically treated with intravenous ceftriaxone (500 mg/8 h). However, she did not respond to the treatment. The urine culture and sensitivity tests, coupled with bacterial whole-genome sequencing (WGS) and analysis, revealed the bacteria to be which was extensively drug-resistant but was susceptible to carbapenems and polymyxins. Based on these findings, meropenem (500 mg/8 h) was administered to the patient, who then responded to the treatment and recovered successfully without having a relapse. This case raises awareness of the importance of diagnosis of not-so-common etiological agents, correct identification of the pathogens, and targeted antibiotic therapy. In conclusion, correctly identifying etiological agents of UTI using WGS approaches that are otherwise difficult to diagnose could help improve the identification of infectious agents and improve the management of infectious diseases.

摘要

作为一种医院病原体,越来越多地与广泛耐药性和毒力特征相关联。它导致高发病率和死亡率。本报告描述了孟加拉国达卡一名患有2型糖尿病(T2D)的老年家庭主妇首例由其引起的社区获得性尿路感染(UTI)成功治疗病例。患者经验性接受静脉注射头孢曲松(500毫克/8小时)治疗。然而,她对治疗无反应。尿液培养和药敏试验,结合细菌全基因组测序(WGS)和分析,显示该细菌为,其具有广泛耐药性,但对碳青霉烯类和多粘菌素敏感。基于这些发现,对患者给予美罗培南(500毫克/8小时)治疗,患者随后对治疗有反应并成功康复且未复发。该病例提高了对诊断不常见病原体、正确识别病原体以及针对性抗生素治疗重要性的认识。总之,使用WGS方法正确识别UTI的病原体,否则难以诊断,这有助于改善感染病原体的识别并改善传染病的管理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0423/10330784/5e9372bba36c/fmed-10-1206756-g0001.jpg

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