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一个由Ralstonia insidiosa引起的脑膜炎病例,这是一个罕见的机会性病原体

Lindan Liao¹, Dan Lin¹, Zhiqiang Liu¹

¹Department of Clinical Pharmacy, The First People's Hospital of Neijiang, 641000, Neijiang, China.

BMC infectious diseases

|August 23, 2023

概括

这份病例报告详细介绍了第一个由Ralstonia insidiosa引起的脑膜炎的案例,这种罕见的格兰氏阴性细菌. 及时识别和治疗塞费皮姆和勒沃素对于患者的康复至关重要.

科学领域:

医学微生物学医学微生物学
传染性疾病传染性疾病
神经科学是一个神经科学.

背景情况:

越来越多地发现一种格拉姆阴性机会性细菌Ralstonia insidiosa,但很少引起严重的感染.
由R. insidiosa引起的脑膜炎非常罕见,以前仅报告了少数呼吸道和血液感染.
这项研究呈现了全球第一个被记录的R. insidiosa脑膜炎病例.

研究的目的:

报告全球第一个由Ralstonia insidiosa引起的脑膜炎病例.
审查这种罕见感染的临床表现,鉴定和治疗.
强调在中枢神经系统术后感染中考虑不常见病原体的重要性.

主要方法:

研究了一例在中国的腰部手术后出现脑膜炎的病例.
大脑脊髓液 (CSF) 培养物鉴定出致病原体为Ralstonia insidiosa.
用矩阵辅助激光脱/离子化飞行时间质谱法 (MALDI-TOF MS) 来快速识别病原体.
由于缺乏敏感性测试,文献审查指导了抗生素选择.

主要成果:

患者出现了头痛,头和反复发烧,对最初的经验性抗生素没有反应.
在CSF培养物中发现了Ralstonia insidiosa.
静脉注射塞费皮姆和勒沃素的治疗导致临床改善.
MALDI-TOF MS使得快速准确的诊断成为可能.

结论:

在不响应标准经验治疗的中枢神经系统术后感染中应考虑R. insidiosa.
这一案例突出了cefepime和levofloxacin作为R.insidiosa脑膜炎的潜在治疗方法.
对Ralstonia spp.进行标准化易感性测试和断点. 随着越来越多的病例出现,需要更多的治疗.

关键词:

感染感染感染脑膜炎是一种脑膜炎.拉尔斯托尼亚是什么意思拉尔斯托尼亚虫 (Ralstonia insidiosa) 是一种的植物.

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