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成功治疗心室辅助装置相关感染继发的复发性广泛耐药菌血症

Successful Treatment of Recurrent Extensively Drug-Resistant Bacteremia Secondary to Ventricular Assist Device-Associated Infection.

作者信息

Vessely Madeleine B, Siddiqui Marrium, Kling Kendall, Guenette Alexis, Bachta Kelly E R

机构信息

Division of Infectious Diseases, Department of Medicine, Northwestern University, Chicago, Illinois, USA.

Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.

出版信息

Open Forum Infect Dis. 2024 Oct 11;11(11):ofae611. doi: 10.1093/ofid/ofae611. eCollection 2024 Nov.

DOI:10.1093/ofid/ofae611
PMID:39494452
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11528664/
Abstract

is an emerging pathogen increasingly implicated in health care-associated infections. Here, we report a case of recurrent ventricular assist device-associated infection caused by multidrug-resistant and describe the clinical course, treatment challenges, and ultimate case resolution. Our results demonstrate that standard clinical methodologies for determining trimethoprim-sulfamethoxazole minimum inhibitory concentration, including VITEK2 and gradient diffusion tests, may be unsuitable for as they result in false-negative susceptibility results. The discrepancy between antimicrobial susceptibility testing reported here highlights the importance of investigating and validating the applicability of standard clinical antimicrobial susceptibility testing and interpretation when treating emerging pathogens such as

摘要

是一种越来越多地与医疗保健相关感染有关的新兴病原体。在此，我们报告一例由多重耐药菌引起的复发性心室辅助装置相关感染病例，并描述其临床过程、治疗挑战及最终病例结局。我们的结果表明，包括VITEK2和梯度扩散试验在内的用于确定甲氧苄啶-磺胺甲恶唑最低抑菌浓度的标准临床方法可能不适用于该菌，因为它们会导致药敏结果出现假阴性。此处报告的抗菌药物敏感性试验之间的差异凸显了在治疗如……等新兴病原体时，研究和验证标准临床抗菌药物敏感性试验及解释的适用性的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1313/11528664/c0010532c6ff/ofae611f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1313/11528664/c0010532c6ff/ofae611f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1313/11528664/c0010532c6ff/ofae611f1.jpg

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本文引用的文献

1
Erratum for Humphries et al., "CLSI Methods Development and Standardization Working Group Best Practices for Evaluation of Antimicrobial Susceptibility Tests".汉弗莱斯等人的《临床和实验室标准协会方法开发与标准化工作组评估抗菌药物敏感性试验的最佳实践》勘误
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2
Characterization of a Novel Pathogen in Immunocompromised Patients: -Exploring the Scope of Resistance to Contemporary Antimicrobial Agents and β-lactamase Inhibitors.免疫功能低下患者中一种新型病原体的特征：探索对当代抗菌药物和β-内酰胺酶抑制剂的耐药范围
Open Forum Infect Dis. 2023 Jan 31;10(2):ofad014. doi: 10.1093/ofid/ofad014. eCollection 2023 Feb.
3
Elizabethkingia anophelis outbreak in France.
法国出现嗜人按蚊伊丽莎白菌疫情。
Infect Dis Now. 2022 Aug;52(5):299-303. doi: 10.1016/j.idnow.2022.05.005. Epub 2022 May 26.
4
Antimicrobial Susceptibility of Species: Report from a Reference Laboratory.种的抗菌药敏性：参考实验室报告。
J Clin Microbiol. 2022 Jun 15;60(6):e0254121. doi: 10.1128/jcm.02541-21. Epub 2022 May 5.
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A Unique Case of Elizabethkingia Associated Cardiac Device Infection.伊丽莎白菌属相关心脏装置感染的一个独特病例。
Cureus. 2021 Nov 30;13(11):e20028. doi: 10.7759/cureus.20028. eCollection 2021 Nov.
6
Comparative Analysis of Gradient Diffusion and Disk Diffusion with Agar Dilution for Susceptibility Testing of .梯度扩散、纸片扩散与琼脂稀释法用于……药敏试验的比较分析
Antibiotics (Basel). 2021 Apr 16;10(4):450. doi: 10.3390/antibiotics10040450.
7
Comparison of three species of Elizabethkingia genus by whole-genome sequence analysis.三种伊丽莎白菌属的全基因组序列分析比较。
FEMS Microbiol Lett. 2021 Apr 8;368(5). doi: 10.1093/femsle/fnab018.
8
Molecular characteristics and in vitro effects of antimicrobial combinations on planktonic and biofilm forms of Elizabethkingia anophelis.伊丽莎白菌属无芽胞厌氧菌的浮游和生物膜形式的抗微生物药物组合的分子特征和体外作用。
J Antimicrob Chemother. 2021 Apr 13;76(5):1205-1214. doi: 10.1093/jac/dkab018.
9
The Society of Thoracic Surgeons Intermacs 2020 Annual Report.《胸外科医师学会 Intermacs 2020 年度报告》。
Ann Thorac Surg. 2021 Mar;111(3):778-792. doi: 10.1016/j.athoracsur.2020.12.038. Epub 2021 Jan 16.
10
Susceptibility of Elizabethkingia spp. to commonly tested and novel antibiotics and concordance between broth microdilution and automated testing methods.伊丽莎白菌属对常用及新型抗生素的敏感性以及肉汤微量稀释法与自动化检测方法之间的一致性。
J Antimicrob Chemother. 2021 Feb 11;76(3):653-658. doi: 10.1093/jac/dkaa499.