Osada Yukari, Oka Keisuke, Iguchi Mitsutaka, Morioka Hiroshi, Iwata Ken-Ichi, Ohara Moeko, Shimaoka Nami, Sawada Tsunaki, Yagi Tetsuya
Department of Clinical Laboratory, Nagoya University Hospital, Aichi, Japan.
Department of Infectious Diseases, Nagoya University Hospital, Aichi, Japan.
J Infect Chemother. 2025 Mar;31(3):102592. doi: 10.1016/j.jiac.2024.12.021. Epub 2024 Dec 17.
A 75-year-old male, hospitalized with back pain, remained hospitalized for tests for unexplained colitis, which was diagnosed as inflammatory bowel disease unclassified and treated with antibiotics and prednisolone, resulting in Clostridioides difficile colitis. Therefore, antibiotics were discontinued, and oral metronidazole treatment was initiated; however, as the patient's fever persisted, blood cultures were performed. An anaerobic bottle of blood culture turned positive the following day. Initial Gram staining of the positive blood culture fluid showed negative rods, and restaining detected small numbers of Gram-positive rods among the Gram-negative rods. The gray colonies on the subculture medium contained only Gram-negative rods. The bacterium was identified as Flavonifractor plautii using mass spectrometry. We ordered the ATCC 29863 F. plautii strain and compared with the strain of this case. The biochemical test result and the change in colony fluorescence under ultraviolet light of the strain isolated from the patient were identical to those of the ATCC strain, supporting the mass spectrometry results. Bacterial translocation from colonic mucosa was suspected, which improved following levofloxacin and metronidazole therapy. Only eight cases of human F. plautii infection have been reported, and we summarized them as a review. Careful and thorough isolation and identification of bacteria that are rarely isolated clinically, such as F. plautii, is crucial in accumulating evidence on rare infectious diseases.
一名75岁男性因背痛住院，因不明原因的结肠炎接受检查，被诊断为未分类的炎症性肠病，接受抗生素和泼尼松龙治疗，结果引发了艰难梭菌结肠炎。因此，停用抗生素，开始口服甲硝唑治疗；然而，由于患者持续发热，进行了血培养。厌氧血培养瓶第二天呈阳性。阳性血培养液的初次革兰氏染色显示为阴性杆菌，复染在革兰氏阴性杆菌中检测到少量革兰氏阳性杆菌。亚培养基上的灰色菌落仅含有革兰氏阴性杆菌。通过质谱法鉴定该细菌为普氏黄酮杆菌。我们订购了ATCC 29863普氏黄酮杆菌菌株，并与本病例的菌株进行比较。从患者分离出的菌株的生化测试结果和在紫外线下菌落荧光的变化与ATCC菌株相同，支持了质谱分析结果。怀疑细菌从结肠黏膜移位，左氧氟沙星和甲硝唑治疗后病情有所改善。仅报告了8例人类普氏黄酮杆菌感染病例，我们对其进行了综述总结。对于临床罕见分离的细菌，如普氏黄酮杆菌，进行仔细彻底的分离和鉴定对于积累罕见传染病的证据至关重要。
