Dhodapkar K M, Henry N K
Department of Pediatric and Adolescent Medicine, Mayo Clinic Rochester, MN 55905, USA.
Mayo Clin Proc. 1996 Dec;71(12):1171-4. doi: 10.4065/71.12.1171.
In this article, we report a case of Leuconostoc bacteremia in a 7-month-old infant who had short-gut syndrome after a gastroschisis repair and who was dependent on total parenteral nutrition through a central venous catheter. The organism was initially misidentified as viridans group streptococcus. Detection of vancomycin resistance led to the correct diagnosis of Leuconostoc species. The patient was successfully treated with ampicillin and an aminoglycoside. A review of the literature revealed prematurity, short-gut syndrome, prior vancomycin use, and central venous catheters as important predisposing factors. Leuconostoc species is an emerging pathogen that should be considered in the differential diagnosis of vancomycin-resistant gram-positive bacteremia, particularly in these clinical settings.
在本文中，我们报告了一例7个月大婴儿的明串珠菌血症病例。该婴儿在腹裂修补术后患有短肠综合征，通过中心静脉导管依赖全肠外营养。该菌最初被误诊为草绿色链球菌属。万古霉素耐药性的检测导致了明串珠菌属的正确诊断。患者用氨苄西林和一种氨基糖苷类药物成功治愈。文献回顾显示早产、短肠综合征、既往使用万古霉素和中心静脉导管是重要的易感因素。明串珠菌属是一种新兴病原体，在耐万古霉素革兰氏阳性菌血症的鉴别诊断中应予以考虑，尤其是在这些临床情况下。
