在免疫功能低下的患者中引起的Vibrio cholerae血清组O24的严重胃肠炎:病例报告
Tomoko Azuma1, Yoshinori Takahashi2, Megumi Oshima3
1Department of Clinical Laboratory, Kanazawa University Hospital, Ishikawa, Japan.
概括
非O1和非O139的振动性霍乱 (NOVC) 可以引起严重的疾病,特别是在免疫功能低下的患者中. 这一案例凸显了传统诊断对于识别不寻常的NOVC菌株,如V. cholerae O24.等常规诊断的重要性.
科学领域:
- 微生物学 微生物学
- 传染性疾病 传染性疾病
- 临床诊断 临床诊断 临床诊断
背景情况:
- 非O1和非O139的振动性霍乱 (NOVC) 通常与轻度胃肠炎有关.
- 越来越多地报告了NOVC的严重感染和致命结果,特别是在免疫受损的个体中.
- 肝硬化等潜在疾病增加了对严重NOVC感染的易感性.
研究的目的:
- 报告一种严重的胃肠炎病例,该病例是由一个不寻常的NOVC菌株引起的,Vibrio cholerae血清组O24.
- 要强调NOVC菌株未被质谱识别所带来的诊断挑战.
- 突出传统微生物学方法在识别V.cholerae.中的持续重要性.
主要方法:
- 从便培养物中分离和识别Vibrio物种.
- 细菌特征的格拉姆染色和生物化学分析.
- 用于识别的矩阵辅助激光脱/离子化飞行时间质谱 (MALDI-TOF MS).
- 基因分析用于菌株确认和数据库验证.
主要成果:
- 一个由V. cholerae O24引起的严重胃肠炎病例,发生在接受普雷迪尼索隆治疗的免疫功能低下患者身上.
- MALDI-TOF MS提供了低可信度的鉴定,表明V.模仿菌或V. albensis.
- 传统的生物化学测试和盐分耐受性证实了该分离物为NOVC.
- 基因分析确定该菌株为V. cholerae O24,在MALDI-TOFMS数据库中没有.
结论:
- 这种病例表明严重的胃肠炎是由于不常见的NOVC菌株V. cholerae O24引起的.
- 传统的诊断方法对于识别新型或数据库缺失的V. cholerae菌株至关重要.
- 免疫受损的个体有较高的风险从NOVC感染的严重后果.
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