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从胸腔感染中分离鉴定出马氏霍利氏菌:一例病例报告。

Isolation and identification of hoylesella marshii causing pleural infection: a case report.

机构信息

Department of Clinical Laboratory Medicine, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, 210008, China.

Department of Clinical Laboratory Medicine, Yancheng Tinghu District People's Hospital, Yancheng, 224001, China.

出版信息

BMC Infect Dis. 2024 Jul 8;24(1):677. doi: 10.1186/s12879-024-09586-5.

Abstract

BACKGROUND

Hoylesella marshii can be isolated from human oral cavities affected by dental pulp and periodontal infections, as well as from the dental plaque of healthy individuals, making it a common bacterium within the oral microbiota. However, its role in causing pleural infections in humans is rare.

CASE PRESENTATION

A case of purulent pleural effusion occurred shortly after discharge in an elderly patient who had undergone surgery for gastric cancer. The infection was identified as being caused by an obligate anaerobe through laboratory culture, and was further identified as Hoylesella marshii causing pleural infection through 16 S rRNA gene sequence analysis. Susceptibility testing guided precise treatment with cefoperazone-sulbactam and metronidazole. The patient's clinical symptoms improved rapidly, laboratory test indicators gradually returned to normal, and the patient ultimately recovered.

CONCLUSION

Hoylesella marshii can cause pleural infections in humans. Clinical microbiology laboratories should pay special attention to the cultivation of obligate anaerobes when routine aerobic cultures do not show bacterial growth but bacteria are visible on smear staining, and when conventional identification methods fail to identify the bacterium, analysis based on the highly conserved 16 S rRNA gene sequence can accurately and specifically identify the bacterium, guiding clinicians in formulating precise anti-infection strategies.

摘要

背景

Hoylesella marshii 可从受牙髓和牙周感染影响的人类口腔以及健康个体的牙菌斑中分离出来,使其成为口腔微生物群中的常见细菌。然而,它在引起人类胸膜感染方面的作用很少见。

病例介绍

一名老年胃癌手术后患者在出院后不久发生脓性胸腔积液。通过实验室培养鉴定感染为专性厌氧菌,并通过 16S rRNA 基因序列分析进一步鉴定为 Hoylesella marshii 引起的胸膜感染。药敏试验指导了头孢哌酮-舒巴坦和甲硝唑的精确治疗。患者的临床症状迅速改善,实验室检测指标逐渐恢复正常,最终患者康复。

结论

Hoylesella marshii 可引起人类胸膜感染。临床微生物学实验室在常规需氧培养未显示细菌生长但涂片染色可见细菌,且常规鉴定方法无法鉴定细菌时,应特别注意专性厌氧菌的培养。基于高度保守的 16S rRNA 基因序列的分析可以准确、特异性地鉴定细菌,指导临床医生制定精确的抗感染策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7bfe/11229267/58f33cf794cf/12879_2024_9586_Fig1_HTML.jpg

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