Department of Critical Care and Emergency Medicine, National Hospital Organization Yokohama Medical Center, 3-60-2 Harajuku, Totsuka-Ward, Yokohama City, Kanagawa, 245-8575, Japan.
Division of Clinical Research, Medical Mycology Research Center, Chiba University, Chiba, Japan.
BMC Infect Dis. 2024 Sep 17;24(1):990. doi: 10.1186/s12879-024-09919-4.
Aspergillus spp. are rare causes of surgical site infections (SSIs). Specifically, Aspergillus section Nigri, commonly identified as Aspergillus niger through morphological findings, has infrequently been reported as an abdominal SSI pathogen.
An 86-year-old woman with a history of hypertension, chronic kidney disease, and atrial fibrillation who was taking 6 mg of prednisolone daily for rheumatoid arthritis was admitted to our hospital because of sudden abdominal pain. She was diagnosed with sigmoid colon perforation and underwent an open Hartmann operation on the day of admission. Subsequently, a superficial abdominal SSI was detected. Through analysis of the calmodulin gene, Aspergillus welwitschiae, which is classified within the Aspergillus section Nigri, was identified as the responsible pathogen. The minimum inhibitory concentration of voriconazole (VRCZ) was 2 mg/L. Surgical removal of the infected tissue and VRCZ administration was effectively used to treat the infection.
Given the reported low susceptibility of Nigri section species to azoles, identification and drug susceptibility testing of these fungi are highly important.
曲霉菌属是少见的手术部位感染（SSI）致病菌。具体来说，黑曲霉组（Aspergillus section Nigri），通过形态学发现通常被鉴定为黑曲霉（Aspergillus niger），其作为腹部 SSI 病原体的报道则较为少见。
一位 86 岁的女性，有高血压、慢性肾脏病和心房颤动病史，因突发腹痛被收入我院，每日服用 6 毫克泼尼松龙治疗类风湿关节炎。她被诊断为乙状结肠穿孔，并在入院当天接受了开放性 Hartmann 手术。随后，发现了一处浅表性腹部 SSI。通过钙调蛋白基因分析，鉴定出负责病原体为黑曲霉组中的构巢曲霉（Aspergillus welwitschiae）。伏立康唑（voriconazole，VRCZ）的最低抑菌浓度为 2 毫克/升。手术切除感染组织并使用 VRCZ 治疗有效地控制了感染。
鉴于报道的黑曲霉组物种对唑类药物的敏感性较低，因此对这些真菌进行鉴定和药敏试验非常重要。
