胆管癌患者胆路感染1例报告。

Q3 Pharmacology, Toxicology and Pharmaceutics Infectious disorders drug targets Pub Date : 2023-01-01 DOI:10.2174/1871526523666230510121447
Neha Sharad, Smriti Srivastava, Aparna Ningombam, Rajesh Malhotra, Purva Mathur
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引用次数: 0

摘要

导言:粪肠球菌和粪肠球菌是引起大多数感染的常见肠球菌。在此之前,除了常见的种类外,其他的种类通常被认为是肠球菌。然而,现代设备,如MALDI-TOF和VITEK2,已经很实用,帮助我们识别以前未识别的物种。hirae是一种很少报道引起人类感染的生物。在此,我们报告一例胆道感染的女性患者胆管癌引起的E. hirae。病例:56岁女性,表现为发热和腹痛。在ERCP期间抽取的胆汁在我们实验室接收。胆汁革兰氏染色显示大量多形核白细胞伴革兰氏阳性双球菌。这种微生物在麦康基琼脂上不能生长。在血琼脂上生长非溶血性菌落。MALDI-TOF ms鉴定该菌为hirae。VITEK2检测结果显示该菌对高剂量庆大霉素耐药,对其余所有药物均敏感。口服环丙沙星成功治疗了感染。讨论:由于胆道梗阻,胆汁被细菌定植,导致胆管炎。这导致细菌增殖和细菌易位进入体循环。我们的病例对高剂量庆大霉素有耐药性,而以前报告的所有病例都是易感的。在牲畜中大量使用抗生素的情况下,从牛及其周围环境中分离出的耐药鼠疫杆菌分离株可能给人类造成困难。因此,应该对家畜抗生素的使用进行监管。此类病例应予以报告,如果不予以报告,就有可能引起疫情。结论:因此,当遇到hirae时,不应忽视,而应将其视为病原体并报告。牛及其周围存在耐药生物,它们可能引起人类感染的人畜共患疾病,以及在牲畜中不受控制地使用抗生素,这些都令人担忧。因此,我们需要在未来对此更加警惕。
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E. hirae Causing Biliary Tract Infection in a Patient with Cholangiocarcinoma: A Case Report.

Introduction: E. faecium and E. faecalis are the common species of Enterococcus responsible for the majority of infections. Earlier, species other than the common ones were usually unidentified and reported as Enterococcus species. However, modern equipment, like MALDI-TOF and VITEK2, have been utilitarian, helping us to identify the previously unidentified species. E. hirae is an organism seldom reported to cause human infections. Here, we report a case of a biliary tract infection in a female patient with cholangiocarcinoma caused by E. hirae.

Case: A 56-year-old female presented with fever and abdominal pain. Bile aspirated during the ERCP was received in our laboratory. The gram stain of the bile sample revealed abundant polymorphonuclear leucocytes along with gram-positive diplococci. The organism failed to grow on MacConkey agar. On blood agar, non-hemolytic colonies grew. The organism was identified as E. hirae by MALDI-TOF MS. The antibiotic susceptibility performed using VITEK2 revealed it to be resistant to high-level gentamicin and susceptible to all remaining drugs. She was successfully treated with oral ciprofloxacin for the infection.

Discussion: Bile is colonized with bacteria due to obstruction in the biliary tree, leading to cholangitis. This causes bacterial proliferation and translocation of bacteria into the systemic circulation. Our case was resistant to high-level gentamicin, while all previously reported cases were susceptible. The resistant isolates of E. hirae being isolated from cattle and their surroundings amidst the rampant use of antibiotics in livestock can pose a difficult situation for humans. Thus, there should be regulations on antibiotic usage in livestock. Cases like these should be reported and recognized for their potential to cause outbreaks if they remain unreported.

Conclusion: Thus, E. hirae, when encountered, should not be ignored but considered a pathogen and reported. The presence of drug-resistant organisms in cattle and their surroundings, their zoonotic potential to cause infections in humans, and the uncontrolled usage of antibiotics in livestock are causes for concern. Thus, we need to be more vigilant regarding it in the future.

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来源期刊
Infectious disorders drug targets
Infectious disorders drug targets Pharmacology, Toxicology and Pharmaceutics-Pharmacology
CiteScore
3.10
自引率
0.00%
发文量
123
期刊介绍: Infectious Disorders - Drug Targets aims to cover all the latest and outstanding developments on the medicinal chemistry, pharmacology, molecular biology, genomics and biochemistry of contemporary molecular targets involved in infectious disorders e.g. disease specific proteins, receptors, enzymes, genes. Each issue of the journal contains a series of timely in-depth reviews written by leaders in the field covering a range of current topics on drug targets involved in infectious disorders. As the discovery, identification, characterization and validation of novel human drug targets for anti-infective drug discovery continues to grow, this journal will be essential reading for all pharmaceutical scientists involved in drug discovery and development.
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