尼日利亚西北部卡齐纳联邦教学医院使用BacT/Alert和VITEK-2紧凑系统从新生儿败血症中分离出血弧菌1例报告

H. Obaro, M. Suleiman, S. A. Yekinni, A. Sanda, B. Aminu
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摘要

新生儿败血症是新生儿发病和死亡的重要原因,主要发生在发展中国家。然而,新生儿败血症的细菌病因及其抗菌药物敏感性模式是动态的。血Globicatella sanguinis是一种链球菌样细菌,能够引起人类严重感染,很少从临床样本中分离出来,是一种罕见的病原体,难以识别。仅基于表型方法的鉴定可能会错误识别许多细菌,这可能会影响精确的抗生素治疗。我们报告在尼日利亚卡齐纳联邦教学医院从一名患有败血症和呼吸窘迫综合征(RDS)的3小时大的早产女性新生儿(28周,极低出生体重)中分离出一种罕见的细菌病原体血毒杆菌,据我们所知,这是世界上极少数报道的病例之一。无菌采集新生儿血液样本,在BacT/Alert自动系统(biomacrieux, Mercy-Etoile,法国)上培养。从阳性培养中鉴定出一种罕见的细菌,并用VITEK-2紧凑系统进行体外药敏试验,结果表明该分离物对庆大霉素、头孢呋辛、头孢曲松和头孢他啶敏感。尽管进行了抗生素治疗和其他标准护理,但在入院第9天,婴儿出现呼吸暂停,所有复苏措施都被证明无效。在尼日利亚这样的儿童因感染死亡率高的发展中国家,采用改进的VITEK-2紧凑型系统、PCR、MALDI-TOF质谱和下一代测序等先进技术可以在减少感染方面发挥重要作用。
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Isolation of Globicatella sanguinis from a neonate with sepsis using BacT/Alert and VITEK-2 compact system at Federal Teaching Hospital, Katsina, northwest Nigeria: A case report
Neonatal sepsis is a significant cause of neonatal morbidity and mortality, predominantly in developing countries. The bacterial causes of neonatal sepsis and their antimicrobial susceptibility patterns are however dynamic. Globicatella sanguinis is a streptococcus-like bacterial agent capable of causing serious infection in humans that has been rarely isolated from clinical samples, and is an uncommon pathogen that is difficult to identify. Identification based on phenotypic methods alone can misidentify many bacteria, and this may affect precise antibiotic treatment. We report the isolation of a rare bacterial pathogen, G. sanguinis from a three-hour-old preterm female neonate (28 weeker, extremely low birth weight) with sepsis and respiratory distress syndrome (RDS) at Federal Teaching Hospital Katsina, Nigeria, and to the best of our knowledge, one of the very few reported cases all over the world. Blood sample was aseptically collected from the neonate and cultured on BacT/Alert automated system (BioMérieux, Mercy-Etoile, France). A rare bacterium was identified from a positive culture, and in vitro susceptibility test using VITEK-2 compact system showed the isolate to be sensitive to gentamicin, cefuroxime, ceftriaxone, and ceftazidime. Despite antibiotic treatment and other standards of care, on day 9 of admission, the baby developed apnea and all resuscitative measures proved abortive. In a developing country like Nigeria where child mortality due to infection is high, the inclusion of advanced technologies such as improved VITEK-2 compact system, PCR, MALDI-TOF MS, and next-generation sequencing, could play a significant role in its reduction.
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