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中国由植物源性固氮菌引起的败血症合并 1 型半乳糖血症:一例报告。

Sepsis caused by Phytobacter diazotrophicus complicated with galactosemia type 1 in China: a case report.

机构信息

Microbiology Laboratory, Quanzhou Women's and Children's Hospital, Quanzhou, People's Republic of China.

The Affiliated Women's and Children's Hospital of Huaqiao University, Quanzhou, People's Republic of China.

出版信息

BMC Infect Dis. 2024 Jun 19;24(1):599. doi: 10.1186/s12879-024-09458-y.

Abstract

BACKGROUND

Phytobacter diazotrophicus (P. diazotrophicus) is an opportunistic pathogen that causes nosocomial outbreaks and sepsis. However, there are no reports of P. diazotrophicus isolated from human blood in China.

CASE PRESENTATION

A 27-day-old female infant was admitted to our hospital with fever and high bilirubin levels. The clinical features included jaundice, abnormal coagulation, cholestasis, fever, convulsions, weak muscle tension, sucking weakness, ascites, abnormal tyrosine metabolism, cerebral oedema, abnormal liver function, clavicle fracture, and haemolytic anaemia. The strain isolated from the patient's blood was identified as P. diazotrophicus by whole-genome sequencing (WGS). Galactosemia type 1 (GALAC1) was diagnosed using whole-exome sequencing (WES). Based on drug sensitivity results, 10 days of anti-infective treatment with meropenem combined with lactose-free milk powder improved symptoms.

CONCLUSION

P. diazotrophicus was successfully identified in a patient with neonatal sepsis combined with galactosemia. Galactosemia may be an important factor in neonatal sepsis. This case further expands our understanding of the clinical characteristics of GALAC1.

摘要

背景

植物杆菌(P. diazotrophicus)是一种机会性病原体,可引起医院感染暴发和败血症。然而,在中国尚无从人血中分离出 P. diazotrophicus 的报道。

病例介绍

一名 27 天的女婴因发热和高胆红素血症入院。临床特征包括黄疸、凝血功能异常、胆汁淤积、发热、抽搐、肌张力减弱、吸吮无力、腹水、酪氨酸代谢异常、脑水肿、肝功能异常、锁骨骨折和溶血性贫血。通过全基因组测序(WGS)从患者血液中分离出的菌株被鉴定为植物杆菌。通过全外显子组测序(WES)诊断为 1 型半乳糖血症(GALAC1)。根据药敏结果,使用美罗培南联合无乳糖奶粉进行 10 天抗感染治疗后,症状得到改善。

结论

成功鉴定出一株新生儿败血症合并半乳糖血症患者的植物杆菌。半乳糖血症可能是新生儿败血症的一个重要因素。该病例进一步扩展了我们对半乳糖血症 1 型的临床特征的认识。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/563d/11186240/8622fb0fd01e/12879_2024_9458_Fig1_HTML.jpg

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