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雷特格变形杆菌多重耐药伤口感染:一例病例报告及文献综述

Wound infection with multidrug-resistant Providencia rettgeri: About a case report and littérature review.

作者信息

Belmahi S, Saddari A, Zrouri H, Sbibih Y, Ben Moussa C, Abdesselami O, Ghomari K, Alla I, Kaddouri S, Idrissi A, Ezrari S, Benaissa E, Ben Lahlou Y, Elouenass M, Maleb A

机构信息

Laboratory of Microbiology, Faculty of Medicine and Pharmacy (University Mohammed the First), Oujda, Morocco.

Laboratory of Microbiology, Mohammed VI University Hospital, Oujda, Morocco.

出版信息

IDCases. 2024 Nov 16;38:e02115. doi: 10.1016/j.idcr.2024.e02115. eCollection 2024.

Abstract

INTRODUCTION AND IMPORTANCE

, a member of the family within the order, is predominantly associated with urinary tract infections in hospitalized individuals, particularly those with indwelling urinary catheters. However, wound infections caused by are exceedingly rare, with an estimated incidence of around 0.1 %. Here, we present a case of wound infection in a healthy child caused by , highlighting the rarity of the organism and emphasizing the importance of prompte identification and appropriate antibiotic therapy.

CASE REPORT

A 4-year-old child presented with a soft tissue abscess in the left calf, following an injury sustained from a tree trunk a few days prior. The patient underwent wound debridement and abscess drainage, followed by empirical antibiotic therapy with amoxicillin and clavulanic acid. Bacteriological samples collected intraoperatively revealed colonies of identified with high certainty using the BD Phoenix™ 100 automated system. Antimicrobial susceptibility testing showed resistance to several antibiotics but sensitivity to third-generation cephalosporins, amikacin, and aztreonam. Antibiotic therapy was adjusted accordingly, leading to clinical improvement and discharge after ten days of hospitalization.

DISCUSSION

, a Gram-negative bacillus, is a rare causative agent of wound infections. While predominantly associated with nosocomial urinary tract infections, it can rarely lead to various other infections, including wound infections, particularly in hospitalized or immunocompromised individuals. Resistance to multiple antibiotics, including carbapenems, poses challenges in treatment selection.

CONCLUSION

This case underscores the importance of considering as a potential pathogen in wound infections, even in healthy individuals. Awareness of its presence and antibiotic susceptibility patterns is crucial for appropriate management and prevention of complications. Further studies are warranted to elucidate the epidemiology and clinical significance of infections in different patient populations.

摘要

引言与重要性

[细菌名称]是[菌属]目[科]的成员,主要与住院患者的尿路感染相关,尤其是那些留置导尿管的患者。然而,由[细菌名称]引起的伤口感染极为罕见,估计发病率约为0.1%。在此,我们报告一例健康儿童由[细菌名称]引起的伤口感染病例,突出该病原体的罕见性,并强调及时识别和适当抗生素治疗的重要性。

病例报告

一名4岁儿童在几天前被树干划伤后,左侧小腿出现软组织脓肿。患者接受了伤口清创和脓肿引流,随后接受阿莫西林和克拉维酸的经验性抗生素治疗。术中采集的细菌学样本显示,使用BD Phoenix™ 100自动化系统高度确定地鉴定出[细菌名称]菌落。药敏试验显示对几种抗生素耐药,但对第三代头孢菌素、阿米卡星和氨曲南敏感。抗生素治疗相应调整,住院十天后临床症状改善并出院。

讨论

[细菌名称]是一种革兰氏阴性杆菌,是伤口感染的罕见病原体。虽然主要与医院获得性尿路感染相关,但它很少能导致各种其他感染,包括伤口感染,特别是在住院或免疫功能低下的个体中。对包括碳青霉烯类在内的多种抗生素耐药,给治疗选择带来挑战。

结论

本病例强调了即使在健康个体中,也应将[细菌名称]视为伤口感染潜在病原体的重要性。了解其存在和抗生素敏感性模式对于适当管理和预防并发症至关重要。有必要进一步研究以阐明[细菌名称]感染在不同患者群体中的流行病学和临床意义。

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