一名肿瘤血液病患者的耐多药脑膜炎伊丽莎白金格菌和粪肠球菌感染

IF 1 Q3 MEDICINE, GENERAL & INTERNAL American Journal of Case Reports Pub Date : 2024-11-22 DOI:10.12659/AJCR.945360
Cristina Motta Ferreira, Maria De Nazare Saunier Barbosa, Guilherme Motta Antunes Ferreira, Joseir Saturnino Cristino, Chesman Da Silva Alves, Erasmo Dos Santos Veira, Larissa Alves Gomes, Vander Silva Souza, Franceline Oliveira Calheiros, William Antunes Ferreira
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引用次数: 0

摘要

背景 本病例报告描述了一例 25 岁男子接受外科手术后被诊断为急性髓性白血病的病例。他被立即送入一家血液和血液治疗专科医院接受化疗,随后发现他同时感染了耐多药的脑膜炎伊丽莎白金菌和粪肠球菌。这两种分离菌通常与医疗相关感染有关。病例报告 本报告中描述的患者接受了开腹探查术,这是一种侵入性外科手术,随后在活检后被确诊为急性髓性白血病。化疗立即开始,在此期间患者出现了感染的临床症状和体征。血液培养发现了粪肠球菌,尿液培养发现了脑膜炎伊丽莎白金菌。这两种细菌的 VITEK-2 抗生素图均显示出多重耐药性。对糖肽进行的 E 测试表明耐药性很强,最低抑菌浓度 (MIC) 超过 256 µg/mL。根据培养和抗生素图谱结果,启动了预防性抗生素治疗,并随后进行了调整。结论 在医疗过程中使用正确的无菌技术至关重要。免疫力严重受损的患者在进行大量手术时,需要采取严格的隔离措施以防止感染,这可能是生与死的区别。及早在实验室鉴定病原体克隆及其抗菌药耐药性特征对于及时进行病原学诊断至关重要。这有助于防止感染扩散和医院感染爆发。
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Multidrug-Resistant Elizabethkingia meningoseptica and Enterococcus faecium Infection in an Oncohematologic Patient.

BACKGROUND This case report describes a case of a 25-year-old man who underwent a surgical procedure and was subsequently diagnosed with acute myeloid leukemia. Following his immediate admission to a specialized hospital unit for hematology and hemotherapy to receive chemotherapy, he was found to have a concurrent infection with multidrug-resistant Elizabethkingia meningoseptica as well as Enterococcus faecium. Both isolates are commonly associated with healthcare-associated infections. CASE REPORT The patient described in this report underwent an exploratory laparotomy, which is an invasive surgical procedure, and was subsequently diagnosed with acute myeloid leukemia following a biopsy. Chemotherapy was initiated immediately, during which the patient developed clinical signs and symptoms of infection. Blood cultures revealed the presence of Enterococcus faecium, while urine cultures identified Elizabethkingia meningoseptica. The VITEK-2 antibiogram for both bacteria revealed a multidrug resistance profile. E-test performed for glycopeptides indicated high-level resistance, with a minimum inhibitory concentration (MIC) exceeding 256 µg/mL. Prophylactic antibiotic therapy was initiated and subsequently adjusted according to the culture and antibiogram results. CONCLUSIONS Use of proper aseptic techniques during medical procedures is essential. Patients with severely compromised immunity undergoing numerous procedures require strict isolation measures to prevent infections, which can make the difference between life and death. Early laboratory identification of pathogenic clones and their antimicrobial resistance profiles is crucial for timely etiological diagnosis. This helps prevent the spread of infections and hospital infection outbreaks.

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来源期刊
American Journal of Case Reports
American Journal of Case Reports Medicine-Medicine (all)
CiteScore
1.80
自引率
0.00%
发文量
599
期刊介绍: American Journal of Case Reports is an international, peer-reviewed scientific journal that publishes single and series case reports in all medical fields. American Journal of Case Reports is issued on a continuous basis as a primary electronic journal. Print copies of a single article or a set of articles can be ordered on demand.
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