Kikuchi K, Totsuka K, Shimizu K, Yoshida K, Kobayashi M, Tomonaga O, Oomori Y, Okada S
Department of Medicine, Tokyo Women's Medical College.
Kansenshogaku Zasshi. 1994 Sep;68(9):1084-92. doi: 10.11150/kansenshogakuzasshi1970.68.1084.
We described three septicemia cases in which blood cultures yielded gram-positive cocci identified as Leuconostoc spp. and Pediococcus spp. Patients were three male adults aged 63 to 71 years with severe underlying diseases, pancreatic cancer, esophageal cancer and diabetes mellitus with chronic renal failure. They had fever and chills at the onsets of septicemia with acute obstructive suppurative cholangitis, acute pneumonia, and infection complicated with invasion sites of esophageal cancer contagious to bronchus and subcutaneous tissue. Blood cultures yielded catalase and oxidase negative highly vancomycin-resistant (MIC: 1024 micrograms/ml <) gram-positive cocci showing alpha or gamma hemolysis on blood agar plates. Two cases were polymicrobial infections. In one case with esophageal cancer, clinical symptoms persisted after the start of antimicrobial chemotherapy and the patient died 10 days later associated with complications of esophageal cancer. Leuconostoc lactis, Leuconostoc mesenteroides subsp. dextranicum, and Pediococcus acidilactici wee identified by physiological reactions. These strains were also highly resistant to teicoplanin and fosfomycin, and tolerant to all rested beta-lactams such as benzylpenicillin. This is the first report in Japan to our knowledge on the identification of Leuconostoc spp. and Pediococcus spp. isolated from human infectious diseases.
我们描述了三例败血症病例，血培养分离出革兰氏阳性球菌，鉴定为明串珠菌属和片球菌属。患者为三名63至71岁的成年男性，患有严重基础疾病，分别为胰腺癌、食管癌以及伴有慢性肾衰竭的糖尿病。败血症发病时，他们伴有发热和寒战，分别并发急性梗阻性化脓性胆管炎、急性肺炎，以及食管癌侵犯支气管和皮下组织部位的感染。血培养分离出过氧化氢酶和氧化酶阴性、对万古霉素高度耐药（MIC：1024微克/毫升<）的革兰氏阳性球菌，在血琼脂平板上呈α或γ溶血。两例为混合感染。其中一例食管癌患者，抗菌化疗开始后临床症状持续存在，10天后患者因食管癌并发症死亡。通过生理反应鉴定出乳酸明串珠菌、右旋糖酐明串珠菌肠膜亚种和嗜酸片球菌。这些菌株对替考拉宁和磷霉素也高度耐药，对所有测试的β-内酰胺类药物如苄青霉素均耐受。据我们所知，这是日本首次报道从人类感染性疾病中分离出明串珠菌属和片球菌属。
