大动脉内移植感染由Mycobacterium abscessus亚种. 获得了克拉里菌素耐药性的massiliense:一个案例报告
Yutaro Akiyama1, Noriko Iwamoto2, Keisuke Kamada3
1Disease Control and Prevention Center, National Center for Global Health and Medicine, 1-21-1, Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan. yakiyama@hosp.ncgm.go.jp.
BMC infectious diseases
|October 17, 2023
概括
本病例报告详细介绍了由Mycobacterium abscessus亚种引起的大动脉内移植感染的第一个实例. 马西里昂斯 (MMA) 的意思. 尽管进行了积极的治疗,但该患者患上了宏类抗药性,这突显了治疗罕见的MMA感染的挑战.
科学领域:
- 传染性疾病 传染性疾病
- 微生物学 微生物学
- 基因组学就是基因组学.
背景情况:
- 这种细菌属于Mycobacterium abscessus亚种. 麻氏菌 (MMA) 是一种快速生长的真菌菌.
- 虽然MMA可以引起各种感染,但以前没有报告过大动脉内移植感染.
- 这项研究呈现了第一个由MMA感染大动脉内移植的记录病例.
研究的目的:
- 报告第一例由Mycobacterium abscessus亚种引起的大动脉内移植感染病例. 马西里昂斯 (MMA) 的意思.
- 调查与这种罕见感染相关的治疗挑战和抗菌素耐药性模式.
主要方法:
- 一个85岁的男性患有大动脉内移植感染的病例介绍.
- 使用遗传测试 (hsp65,rpoB,soda) 和全基因组测序 (WGS) 识别MMA.
- 监测治疗反应,抗微生物敏感性测试,以及对治疗前后菌株的WGS分析.
主要成果:
- 患者发烧和腹部疼痛后大动脉内移植插入,诊断为内移植感染.
- 最初的宽谱抗生素无效;发现了MMA.
- 在治疗期间,MMA菌株获得了克拉胺素耐药性,WGS显示了新的耐药性突变.
- 尽管多种药物治疗,感染进展,导致患者死亡.
结论:
- 大动脉内移植感染的MMA是非常罕见的.
- 在对内移植感染进行无效的广泛抗微生物治疗的情况下,应考虑使用MMA.
- 这一案例凸显了MMA在治疗期间快速获得抗菌素耐药性的潜力.
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