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皮氏罗尔斯顿菌:摩洛哥儿科重症监护病房的两例菌血症病例

Ralstonia pickettii: Two Cases of Bacteremia in a Moroccan Pediatric Intensive Care Unit.

作者信息

Nabih Ibtissam, Idbaha Youssef, Aissaoui Ouissal

机构信息

Anesthesia and Critical Care, Ibn Rochd University Hospital, Hassan II University of Casablanca, Casablanca, MAR.

出版信息

Cureus. 2025 Apr 13;17(4):e82189. doi: 10.7759/cureus.82189. eCollection 2025 Apr.

Abstract

is an emerging opportunistic pathogen in hospital settings, particularly affecting immunocompromised patients. Its ability to persist in aqueous solutions and colonize medical devices contributes to nosocomial outbreaks, complicating infection prevention and management strategies. We report two cases of bloodstream infections in the pediatric intensive care unit of a Moroccan university hospital. The first case involved an 11-month-old infant admitted with febrile respiratory distress. Despite initial treatment with imipenem and amikacin, bacteremia was diagnosed on day 30, requiring the addition of colistin and tigecycline. The clinical course was unfavorable, leading to death on day 40. The second case concerned a four-year-old child hospitalized for febrile status epilepticus. On day 10, a polymicrobial nosocomial infection involving , , and was identified, prompting treatment with colistin, tigecycline, and voriconazole. Despite therapeutic interventions, the patient succumbed to the infection on day 28. The emergence of as a nosocomial pathogen necessitates reinforced infection control measures, improved diagnostic capabilities, and the development of tailored therapeutic protocols. Strict adherence to aseptic procedures and continuous hospital surveillance are essential to prevent the spread of this opportunistic bacterium.

摘要

是医院环境中一种新兴的机会性病原体,尤其影响免疫功能低下的患者。它在水溶液中持续存在并在医疗设备上定殖的能力导致医院感染暴发,使感染预防和管理策略复杂化。我们报告了摩洛哥一家大学医院儿科重症监护病房的两例血流感染病例。第一例涉及一名11个月大的婴儿,因发热性呼吸窘迫入院。尽管最初使用亚胺培南和阿米卡星进行治疗,但在第30天诊断出菌血症,需要加用黏菌素和替加环素。临床过程不利,导致在第40天死亡。第二例涉及一名因发热性癫痫持续状态住院的4岁儿童。在第10天,发现了一种包括、和的多微生物医院感染,促使使用黏菌素、替加环素和伏立康唑进行治疗。尽管进行了治疗干预,患者仍在第28天死于感染。作为医院病原体的出现需要加强感染控制措施、提高诊断能力以及制定针对性的治疗方案。严格遵守无菌程序和持续的医院监测对于预防这种机会性细菌的传播至关重要。

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