Wang Shouping, Niu Wang, Lv Tao, Xie Kunlin
Department of Intensive Care Unit, West China Hospital, Sichuan University, Chengdu, China.
Department of Anesthesiology, West China Hospital, Sichuan University and the Research Units of West China (2018RU012), Chinese Academy of Medical Sciences, Chengdu, China.
BMC Infect Dis. 2025 Mar 15;25(1):364. doi: 10.1186/s12879-025-10771-3.
Phocaeicola vulgatus (P.vulgatus) is a member of Bacteroides fragilis Group(BFG). Septic shock caused by P.vulgatus has not been reported yet. In recent years, BFG have attracted much clinical attention. BFG are the commensal microbiota residing in human mucosal sites, most notably the gut, that provide several benefits to healthy hosts. Yet BFG can cause devastating infections when they gain access to normally sterile body compartments following trauma, surgery, or mucosal barrier disruption.
We report a case of septic shock event in a middle-aged male who underwent surgical intervention for a gallbladder mass incidentally detected during routine abdominal CT screening. P.vulgatus was isolated and cultured from blood sample and abdominal drainage fluid after surgery. We further performed the Metagenomic Next-Generation Sequencing (mNGS) with pathological slices of colon and hepatobiliary tissue, and result of mNGS also showed P.vulgatus. The patient was treated with comprehensive therapies and had a good outcome.
To the best of our knowledge, septic shock secondary to P.vulgatus infection originating from non-gastrointestinal area represents an rare clinical condition. We realized that research on BFG should not only focus on its positive effects on the intestine, but also on its potential pathogenicity, including intra-abdominal infections, abscesses, and bloodstream infection.
普通拟杆菌（P.vulgatus）是脆弱拟杆菌群（BFG）的成员之一。由普通拟杆菌引起的感染性休克尚未见报道。近年来，BFG引起了临床的广泛关注。BFG是存在于人体黏膜部位（最显著的是肠道）的共生微生物群，对健康宿主有诸多益处。然而，当BFG在创伤、手术或黏膜屏障破坏后进入通常无菌的体腔时，可导致严重感染。
我们报告一例中年男性感染性休克事件，该患者因在常规腹部CT筛查中偶然发现胆囊肿物而接受手术治疗。术后从血样和腹腔引流液中分离培养出普通拟杆菌。我们进一步对结肠和肝胆组织病理切片进行了宏基因组下一代测序（mNGS），mNGS结果也显示为普通拟杆菌。该患者接受了综合治疗，预后良好。
据我们所知，源自非胃肠道区域的普通拟杆菌感染继发感染性休克是一种罕见的临床情况。我们认识到，对BFG的研究不仅应关注其对肠道的积极作用，还应关注其潜在致病性，包括腹腔内感染、脓肿和血流感染。
