1IHU-Méditerranée Infection, Marseille, France.
2Aix Marseille University, IRD, AP-HM, MEPHI, Marseille, France.
Acta Microbiol Immunol Hung. 2024 Mar 11;71(1):76-81. doi: 10.1556/030.2024.02240. Print 2024 Mar 26.
We report a case of exposure to Coxiella burnetii in a surgical nurse who underwent an injury of her finger with a scalpel blade during a native aortic valve replacement with a bio-prosthetic cardiac valve conducted on a patient suffering from C. burnetii aortic endocarditis. Given the positivity of C. burnetii culture and PCR from the patient's aortic valve, she was prescribed prophylactic doxycycline 100 mg twice a day for 10 days. Q fever is an occupational zoonosis resulting usually of exposure to infected animals by inhalation of infected aerosols or consumption of contaminated raw milk. Apart from materno-foetal transmission, about 180 cases of human-to-human C. burnetii transmission have been published from 1949 to today, including transmission by blood transfusion, sexual relations, transmission in the healthcare setting to staff, patient attendants and other patients that were likely infected from inhalation of aerosol from respiratory or placental products, transmission to staff during autopsies of patients with Q fever and transmission in familial settings. As C. burnetii is a highly infectious bacterium, that may cause infection with a low inoculum, it should be added to the list of organisms which may be of concern following blood exposure among healthcare professionals.
我们报告了一例在外科护士身上发生的接触伯氏考克斯体的病例。该护士在为一名患有伯氏考克斯体感染性心内膜炎的患者进行生物假体心脏瓣膜的原生主动脉瓣置换术时，其手指被手术刀刀片割伤。鉴于患者主动脉瓣的伯氏考克斯体培养和 PCR 均为阳性，她被开处预防性多西环素 100mg，每日两次，共 10 天。Q 热是一种职业性人畜共患病，通常是通过吸入感染性气溶胶或食用受污染的生奶而接触受感染的动物而发生。除了母婴传播外，自 1949 年至今，已发表了约 180 例人与人之间的伯氏考克斯体传播病例，包括通过输血、性接触、在医疗保健环境中向工作人员、病人护理人员和其他可能通过呼吸或胎盘产品的气溶胶吸入而感染的病人传播，在对 Q 热患者进行尸检时向工作人员传播，以及在家庭环境中传播。由于伯氏考克斯体是一种具有高度传染性的细菌，其感染可能只需低剂量接种物，因此应将其添加到医护人员血液暴露后可能引起关注的生物体清单中。
