Yu W L, Lin C W, Wang D Y
Department of Internal Medicine, China Medical College Hospital.
J Formos Med Assoc. 1998 Feb;97(2):106-12.
Ochrobactrum anthropi is an oxidase-positive, nonfermenting, gram-negative bacillus that is an emerging pathogen in immunocompromised patients, particularly in those with indwelling central venous catheters. Reports of clinical manifestation of O. anthropi bacteremia are rare. Herein, we report the clinical and microbiologic characteristics of O. anthropi bacteremia in 15 patients. There were eight males and seven females, whose ages ranged from 1 month to 84 years (mean, 34 years). Ten infections were community acquired. All patients had severe underlying disease and manifested primary O. anthropi bacteremia with no obvious focus. Only three patients had central venous catheters in place at the onset of bacteremia, but none of these showed evidence of catheter-related infection. The mean duration of fever was 4 days (range 0-11) and the mean white blood cell count was 13 x 10(9)/L (range 5.5-28 x 10(9)). All O. anthropi isolates tested were resistant to ampicillin, cephalothin, cefonicid, amoxicillin/clavulanic acid, piperacillin, aztreonam, and ceftazidime, and all were susceptible to gentamicin, amikacin, imipenem, ceftriaxone, and cefoperazone. Most were also susceptible to cefotaxime and moxalactam. Monotherapy with an aminoglycoside or an appropriate beta-lactam (such as cefotaxime or ceftriaxone) yielded good clinical response. None of the 15 patients died directly from O. anthropi bacteremia. Our findings indicate that O. anthropi is often community acquired and can be pathogenic in critically ill or immunocompromised patients with or without indwelling catheters. Although O. anthropi can produce clinically significant infections, the organism seems to be of relatively low virulence.
嗜人按蚊是一种氧化酶阳性、不发酵、革兰氏阴性杆菌，是免疫功能低下患者尤其是留置中心静脉导管患者中新兴的病原体。关于嗜人按蚊菌血症临床表现的报道很少。在此，我们报告15例嗜人按蚊菌血症患者的临床和微生物学特征。其中男性8例，女性7例，年龄从1个月至84岁（平均34岁）。10例感染为社区获得性。所有患者均有严重基础疾病，表现为原发性嗜人按蚊菌血症，无明显病灶。菌血症发作时只有3例患者有中心静脉导管，但这些患者均未显示导管相关感染的证据。发热平均持续时间为4天（范围0 - 11天），平均白细胞计数为13×10⁹/L（范围5.5 - 28×10⁹）。所有检测的嗜人按蚊分离株均对氨苄西林、头孢噻吩、头孢尼西、阿莫西林/克拉维酸、哌拉西林、氨曲南和头孢他啶耐药，对庆大霉素、阿米卡星、亚胺培南、头孢曲松和头孢哌酮均敏感。大多数对头孢噻肟和莫西沙星也敏感。用氨基糖苷类或合适的β-内酰胺类（如头孢噻肟或头孢曲松）单药治疗产生了良好的临床反应。15例患者均未直接死于嗜人按蚊菌血症。我们的研究结果表明，嗜人按蚊常为社区获得性，在有或无留置导管的重症或免疫功能低下患者中均可致病。虽然嗜人按蚊可引起具有临床意义的感染，但该菌的毒力似乎相对较低。
