Bonatti Hugo J R, Gona Sridhar, George Aaron
Meritus Health, Hagerstown, Maryland, USA.
University of Maryland School of Medicine, Baltimore, Maryland, USA.
Surg Infect (Larchmt). 2025 Aug;26(6):365-370. doi: 10.1089/sur.2024.023. Epub 2025 Apr 11.
(TP), previously known as , is a rare and potentially underreported pathogen. TP may cause a variety of infections, including the potential as an important pathogen of intra-abdominal infections (IAIs). Still little data on this anaerobic gram-positive rod are available. The institutional database was searched for TP infections during a 4-year period. Isolation and identification of the pathogen were done according to standard guidelines, including those for anaerobic culture. A total of 21 patients, including 11 males and 10 females, with a median age of 63.8 (range 35.8-90) years with infections because of TP (24 isolates) were identified. There were eight IAIs, 12 soft tissue infections, and 1 pleural empyema; two patients had bacteremia. In 19 cases, microscopy was done revealing white blood cells in 79%, gram-positive cocci in 53%, gram-negative rods in 47%, and gram-positive rods in 32%. Final cultures grew TP monoculture in 38%; in 62%, TP was part of a mixed flora. Twenty-four co-pathogens were identified, including gram-positive cocci (13), gram-negative rods (9), and gram-positive rods (2). Treatment consisted of antibiotic agents, including beta-lactams, clindamycin, or metronidazole, and surgery or interventional drainage for the majority of cases. Outcomes were generally favorable with 19 of the 21 patients surviving. This is a first large series of infections because of the emerging pathogen TP from a rural area. TP mainly causes purulent infections requiring surgical intervention. The series emphasizes the importance of anaerobic cultures in surgical specimens.
破伤风梭菌（TP），以前称为 ，是一种罕见且可能未被充分报告的病原体。TP 可能导致多种感染，包括作为腹腔内感染（IAIs）的重要病原体的可能性。关于这种厌氧革兰氏阳性杆菌的可用数据仍然很少。在机构数据库中搜索了4年期间的TP感染情况。病原体的分离和鉴定按照标准指南进行，包括厌氧培养的指南。共确定了21例患者，包括11名男性和10名女性，中位年龄为63.8岁（范围35.8 - 90岁），因TP感染（24株分离菌）。有8例IAIs，12例软组织感染，1例胸膜脓胸；2例患者有菌血症。在19例病例中进行了显微镜检查，结果显示79%有白细胞，53%有革兰氏阳性球菌，47%有革兰氏阴性杆菌，32%有革兰氏阳性杆菌。最终培养结果显示38%为TP单一培养物；62%的情况下，TP是混合菌群的一部分。确定了24种共病原体，包括革兰氏阳性球菌（13种）、革兰氏阴性杆菌（9种）和革兰氏阳性杆菌（2种）。治疗包括使用抗生素，如β-内酰胺类、克林霉素或甲硝唑，大多数病例还进行了手术或介入引流。总体结果良好，21例患者中有19例存活。这是来自农村地区的关于新兴病原体TP感染的首个大型系列研究。TP主要引起需要手术干预的化脓性感染。该系列研究强调了手术标本厌氧培养的重要性。
