Shirakura Kentaro, Saijo Masaji, Yamada Tatsuya, Song Myeongcheol, Constantine Shadia
Sapporo Tokushukai Hospital Sapporo Japan.
Clin Case Rep. 2023 Sep 19;11(9):e7920. doi: 10.1002/ccr3.7920. eCollection 2023 Sep.
is a Gram-negative bacterium, usually considered a nosocomial pathogen. Its role in community-acquired infections has been reported, but it is still not typically included in differential diagnoses of patients not exposed to the healthcare system. Recently, some reports suggested that liver diseases might also act as a possible risk factor for community-acquired bloodstream infection. We report a case of a 77-year-old woman with a history of cirrhosis who was diagnosed with community-acquired bloodstream infection. not only causes hospital-acquired infections but is also emerging as a pathogen in community settings. Although community-onset infection is still rare and might have lower mortality, this antibiotic-resistant bacterial species should be considered a possible pathogen in patients with liver cirrhosis. Although trimethoprim-sulfamethoxazole is considered the first-line treatment, a study in vitro and a 4-year review of susceptibility in our institution found that the bacteria were more susceptible to minocycline than to trimethoprim-sulfamethoxazole. Therefore, minocycline might become the first-line treatment in the future.
是一种革兰氏阴性菌，通常被认为是医院病原体。其在社区获得性感染中的作用已有报道，但在未接触医疗系统的患者的鉴别诊断中通常仍未被纳入。最近，一些报告表明，肝脏疾病也可能是社区获得性血流感染的一个潜在危险因素。我们报告一例77岁有肝硬化病史的女性被诊断为社区获得性血流感染的病例。不仅会引起医院获得性感染，而且在社区环境中也正成为一种病原体。尽管社区发病感染仍然罕见且死亡率可能较低，但这种耐抗生素细菌应被视为肝硬化患者的一种潜在病原体。虽然甲氧苄啶-磺胺甲恶唑被认为是一线治疗药物，但一项体外研究以及我们机构对4年药敏情况的回顾发现，该细菌对米诺环素比对甲氧苄啶-磺胺甲恶唑更敏感。因此，米诺环素未来可能会成为一线治疗药物。
