Duan Xuehong, Wang Le, Fan Ning, Li Teng, Guo Jian
Department of Laboratory Medicine, The First People's Hospital of Xianyang, Xianyang, People's Republic of China.
Department of Laboratory Medicine, Xianyang Hospital of Yan' an University, Xianyang, People's Republic of China.
Infect Drug Resist. 2024 Dec 24;17:5795-5801. doi: 10.2147/IDR.S478555. eCollection 2024.
is usually found in urogenital tract infections and is associated with several extra-genitourinary infections, including septic arthritis, bacteremia, and meningitis. Here, we report a rare case of induced bloodstream infection with thoracic inflammation in a surgical patient.
A 56-year-old male who underwent surgery for multiple pelvic and rib fractures developed fever, pleural effusion, and wound exudation despite receiving prophylactic anti-infection treatment with cefotiam. Then, replacing the broad-spectrum antimicrobial drugs such as biapenem, imipenem, linezolid still had no obvious curative effect. Meanwhile, a total of 4 groups of blood cultures were collected from patients, of which 2 groups reported positive results 2 to 3 days after specimen collection. At the same time, the patient's pleural effusion and wound pus were also cultured, and transparent needle-like small colonies grew on Columbia blood agar plates within 2 to 3 days after inoculation.
The cultured transparent pinpoint-like small colonies were identified as by matrix-assisted laser desorption-ionization time-of-flight mass spectrometry (MALDI-TOF MS) and 16SrRNA sequencing. The results of antibiotic susceptibility testing (AST) showed that was susceptible to doxycycline, minocycline, josamycin, sparfloxacin, and spectinomycin but resistant to azithromycin, clarithromycin, norfloxacin, roxithromycin, and ofloxacin. According to the AST results and clinical symptoms, moxifloxacin was selected as targeted therapy for infection, and cefoperazone/sulbactam was combined to prevent the infection of other gram-negative bacteria. Finally, the patient was cured successfully.
Although bloodstream and thoracic infections are rare, they cannot be ignored. is intrinsically resistant to agents that work on bacterial cell wall synthesis used. Fluoroquinolones could be kept as potential active and thus a likely curative factor. When routine empirical anti-infection treatment is ineffective, the pathogen should be identified as early as possible. If necessary, gene sequencing technology should be used for diagnosis and sensitive anti-infection drug treatment should be promptly administered to reduce the risk of bloodstream infections.
通常见于泌尿生殖道感染，并与多种泌尿外感染有关，包括脓毒性关节炎、菌血症和脑膜炎。在此，我们报告一例外科手术患者罕见的因[具体病菌名称未给出]导致的血流感染伴胸腔炎症病例。
一名56岁男性因多处骨盆和肋骨骨折接受手术，尽管接受了头孢替安预防性抗感染治疗，但仍出现发热、胸腔积液和伤口渗出。随后，更换为比阿培南、亚胺培南、利奈唑胺等广谱抗菌药物，仍无明显疗效。同时，共从患者采集4组血培养标本，其中2组在标本采集后2至3天报告阳性结果。同时，对患者的胸腔积液和伤口脓液也进行培养，接种后2至3天在哥伦比亚血琼脂平板上长出透明针状小菌落。
通过基质辅助激光解吸电离飞行时间质谱（MALDI-TOF MS）和16SrRNA测序，将培养出的透明针尖状小菌落鉴定为[具体病菌名称未给出]。药敏试验（AST）结果显示，[具体病菌名称未给出]对多西环素、米诺环素、交沙霉素、司帕沙星和大观霉素敏感，但对阿奇霉素、克拉霉素、诺氟沙星、罗红霉素和氧氟沙星耐药。根据AST结果和临床症状，选择莫西沙星作为针对[具体病菌名称未给出]感染的靶向治疗药物，并联合头孢哌酮/舒巴坦预防其他革兰氏阴性菌感染。最终，患者成功治愈。
尽管[具体病菌名称未给出]血流感染和胸腔感染罕见，但不能忽视。[具体病菌名称未给出]对作用于细菌细胞壁合成的药物具有内在耐药性。氟喹诺酮类药物可能保持潜在活性，因此可能是一个治愈因素。当常规经验性抗感染治疗无效时，应尽早鉴定病原体。必要时，应使用基因测序技术进行诊断，并及时给予敏感抗感染药物治疗，以降低血流感染风险。
