Thau Nguyen Sy, Van Dong Do, Nhan Pham Thi Thanh, Van Tuan Nguyen, Sang Vu Viet
108 Military Central Hospital, Vietnamese - German Center for Medical Research (VG-CARE), N 1, Tran Hung Dao Str., Hai Ba Trung Dist, Hanoi, 1000, Vietnam.
108 Military Central Hospital, Institue of Clinical Infectious Disease, N 1, Tran Hung Dao Str., Hai Ba Trung Dist, Hanoi, 1000, Vietnam.
BMC Infect Dis. 2024 Dec 18;24(1):1409. doi: 10.1186/s12879-024-10326-y.
Citrobacter youngae (C. youngae) was first described in 1993, and data suggesting that human diseases caused by this bacterium remain scarce. Reports on C. youngae infections mostly described local infections without evidenced bacteremia, especially in immunocompromised patients. Herein, we report a rare case of bacteremia with intervertebral disc and adjacent vertebral infection due to C. youngae (detected by the Vitek 2 Compact). A 70-year-old man with chronic lower back pain due to lumbar disc herniation underwent microdiscectomy, a minimally invasive spinal surgery. On postoperative day 4, he suffered shaking chills with worsened lower back pain compared to that before the operation, and vancomycin plus ceftriaxone were empirically administered. Magnetic resonance imaging (MRI) of the lumbar spine revealed osteomyelitis at L4 and L5 with L4/L5 discitis. Two blood culture sets were positive with the same pathogen, possibly C. youngae; The patient was then treated successfully with ceftazidime plus ciprofloxacin, the antibiotics were selected based on antibiotic susceptibility test results. This report suggests that C. youngae may cause severe infections in immunocompetent patients, and further surveillance should be considered to monitor antibiotic-resistant bacteria.
杨氏柠檬酸杆菌（C. youngae）于1993年首次被描述，目前关于该细菌引起人类疾病的数据仍然很少。关于杨氏柠檬酸杆菌感染的报告大多描述的是无菌血症证据的局部感染，尤其是在免疫功能低下的患者中。在此，我们报告一例罕见的由杨氏柠檬酸杆菌（通过Vitek 2 Compact检测到）引起的椎间盘及相邻椎体感染伴菌血症的病例。一名因腰椎间盘突出症患有慢性下背痛的70岁男性接受了微创脊柱手术——显微椎间盘切除术。术后第4天，他出现寒战，下背痛较术前加重，经验性给予万古霉素加头孢曲松。腰椎磁共振成像（MRI）显示L4和L5椎体骨髓炎伴L4/L5椎间盘炎。两组血培养结果均为同一病原体阳性，可能为杨氏柠檬酸杆菌；随后根据药敏试验结果选择头孢他啶加环丙沙星对患者进行成功治疗。本报告提示杨氏柠檬酸杆菌可能在免疫功能正常的患者中引起严重感染，应考虑进一步监测以监测耐药菌。
