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病例分析

肺腺癌患者血流感染哈特草螺菌的相关研究

  • 王群 ,
  • 张丽 ,
  • 吴卫星 ,
  • 谢争华
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  • 国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院深圳医院检验科,广东 深圳 518116

收稿日期: 2023-09-05

  网络出版日期: 2023-12-25

基金资助

深圳市恶性肿瘤临床医学研究中心(深科技创新[2021]287号);中国医学科学院肿瘤医院深圳医院青年启动基金资助项目(E010321008)

Study on blood infection of Herbaspirillum huttiense in patient with lung adenocarcinoma

  • WANG Qun ,
  • ZHANG Li ,
  • WU Weixing ,
  • XIE Zhenghua
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  • Department of Laboratory Medicine, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen 518116, Guangdong Province, China

Received date: 2023-09-05

  Online published: 2023-12-25

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摘要

本研究旨在分析肿瘤患者血流感染哈特草螺菌的鉴定及药敏特点,同时对相关菌株感染病例进行回顾分析,为临床治疗提供指导依据。将1例肺腺癌患者放疗后留取的血培养阳性标本进行涂片、染色、镜检,同时采用VITEK MS全自动微生物质谱检测系统、VITEK 2 Compact全自动微生物分析系统和分子测序技术对该分离株进行鉴定分析,并参照其他非发酵革兰氏阴性杆菌药敏实验标准进行药敏试验。结果显示,该分离株为革兰氏阴性杆菌,在血平板上呈乳白色、胶状、凸起、无溶血菌落。VITEK MS质谱仪和分子测序技术将此菌株均鉴定为哈特草螺菌(Herbaspirillum huttienseH. huttiense),VITEK 2 Compact将其鉴定为洋葱伯克霍尔德菌。药敏试验结果显示,该菌对氨曲南中介,对亚胺培南、美洛培南、头孢哌酮/舒巴坦钠、头孢他啶、头孢吡肟、哌拉西林/他唑巴坦和左氧氟沙星等抗菌药物均敏感。本研究报告了哈特草螺菌的生物学特征和病例的诊疗过程,强调了多种诊断技术联合应用在罕见菌鉴定中的重要性。

本文引用格式

王群 , 张丽 , 吴卫星 , 谢争华 . 肺腺癌患者血流感染哈特草螺菌的相关研究[J]. 微生物与感染, 2023 , 18(6) : 346 -352 . DOI: 10.3969/j.issn.1673-6184.2023.06.004

Abstract

The purpose of the current study is to analyze the identification and antimicrobial susceptibility characteristics of Herbaspirillum huttiense (H. huttiense) which was isolated from a lung adenocarcinoma patient with bloodstream infection, and review the literature in search of any similar cases of this rare condition to provide guidance for clinical treatment. The positive blood culture samples from a patient with lung adenocarcinoma after radiotherapy was smeared, gram stained and examined under microscope. At the same time, VITEK MS automatic microbial mass spectrometry system, VITEK 2 Compact automatic microbial analysis system and molecular sequencing technology were used to identify and analyze the isolate. And the antimicrobial susceptibility was determined by the broth microdilution method according to the Clinical and Laboratory Standards Institute (CLSI) guidelines for non-fermented Gram-negative bacilli. The results demonstrated that the strain was Gram-negative rods. And the colonies on the blood plate were milky, gelatinous, raised and without hemolytic. The strain was identified as H. huttiense by VITEK MS mass spectrometer and molecular sequencing technology, but identified as Burkholderia cepacia by VITEK 2 Compact. The results of antimicrobial susceptibility showed that the strain was intermediate to aztreonam, and sensitive to imipenem, meropenem, cefoperazone/sulbactam sodium, ceftazidime, cefepime, piperacillin/tazobactam and levofloxacin. This study describes the biological characteristics and the approach to diagnosis and treatment of H. huttiense, which emphasizes the importance of multiple diagnostic techniques in the identification of rare bacteria.
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