Watanabe Naoki, Watari Tomohisa, Hosokawa Naoto, Otsuka Yoshihito
Emerg Infect Dis. 2025 Apr;31(4):652-661. doi: 10.3201/eid3104.241284.
The clinical characteristics of Alistipes bacteremia remain insufficiently understood. We retrospectively analyzed 13 cases of Alistipes bacteremia at a tertiary care center in Japan. Of the 13 patients, 7 were male and 6 female; 10 were >65 years of age. Of 9 patients with comorbidities, 7 had solid tumors or hematological malignancies and 11 had gastrointestinal symptoms. Isolates identified were Alistipes finegoldii in 4 cases, A. onderdonkii in 4, A. putredinis in 3, A. indistinctus in 2, and A. ihumii in 1. Ten strains exhibited low MICs against β-lactam/β-lactamase inhibitors and metronidazole. We observed high MICs against penicillin, ceftriaxone, and minocycline. Several strains harbored antimicrobial resistance genes, including adeF, tet(Q), cfxA3, cfxA4, and ermG. Twelve patients received β-lactam/β-lactamase inhibitors; 2 patients with solid tumors experienced septic shock and died. Alistipes bacteria can translocate from the gastrointestinal tract into the bloodstream, particularly in cases of inflammation, obstruction, or perforation, leading to severe infections.
对解脲类杆菌血症的临床特征仍了解不足。我们回顾性分析了日本一家三级医疗中心的13例解脲类杆菌血症病例。13例患者中，男性7例，女性6例；10例年龄>65岁。9例合并症患者中，7例患有实体瘤或血液系统恶性肿瘤，11例有胃肠道症状。鉴定出的分离株中，解脲纤细杆菌4例，翁氏解脲类杆菌4例，腐败解脲类杆菌3例，模糊解脲类杆菌2例，伊氏解脲类杆菌1例。10株菌株对β-内酰胺/β-内酰胺酶抑制剂和甲硝唑的最低抑菌浓度较低。我们观察到对青霉素、头孢曲松和米诺环素的最低抑菌浓度较高。部分菌株携带耐药基因，包括adeF、tet(Q)、cfxA3、cfxA4和ermG。12例患者接受了β-内酰胺/β-内酰胺酶抑制剂治疗；2例实体瘤患者发生感染性休克并死亡。解脲类杆菌可从胃肠道转移至血液中，尤其是在发生炎症、梗阻或穿孔的情况下，从而导致严重感染。
