引起导管相关血流感染的草螺菌属Herbaspirillum huttiense鉴定及药敏分析  

Identification and antibiotics sensitivity analysis of Herbaspirillum huttiense in catheter-related bloodstream infection

作　　者：胡秀梅[1] 杨彪 林丽[1] 肇恒瑞 陈晶[1] 周芳[1] 苏冰[1] 芮勇宇[1] 王前[1] 郑磊[1] Hu Xiumei;Yang Biao;Lin Li;Zhao Hengrui;Chen Jing;Zhou Fang;Su Bing;Rui Yongyu;Wang Qian;Zheng Lei(Department of Laboratory Medicine,Nanfang Hospital,Southern Medical University,Guangzhou 510515,China;Department of Laboratory Medicine,Zhujiang Hospital,Southern Medical University,Guangzhou 510280,China)

机构地区：[1]南方医科大学南方医院检验医学科,广州510515 [2]南方医科大学珠江医院医学检验科,广州510280

出　　处：《中华检验医学杂志》2020年第5期582-586,共5页Chinese Journal of Laboratory Medicine

基　　金：国家自然科学基金(81601819);广东省医学科学技术研究基金(A2016280);南方医科大学南方医院杰青培育计划项目(2016J013)。

摘　　要：目的分析导管相关性血流感染草螺菌属的鉴定和药敏试验过程,提高临床医师和微生物检验工作者对罕见病原微生物关注和认知。方法采集1例慢性肾衰竭血液透析患者经透析导管留取的血培养阳性标本,涂片、染色、镜检,并对分离到单个菌落,分别进行质谱分析、生化鉴定和药敏试验;提取细菌基因组DNA,扩增细菌16S rDNA并测序;细菌基因组高通量测序。结果血培养瓶孵育20 h后阳性报警,涂片见革兰阴性杆菌。血琼脂上孵育16 h,见乳白色、凸起和无溶血菌落。VITEK2 Compact鉴定为洋葱伯克霍尔德菌,N335药敏卡检测药敏结果,发现该菌对氨曲南和多黏菌素耐药,其余抗生素均敏感。VITEK MS质谱仪临床数据库无法鉴定出种属,VITEK MS科研数据库鉴定为Herbaspirillum huttiense/Herbaspirillum aquaticum。该菌16S rDNA与草螺菌属Herbaspirillum huttiense、Herbaspirillum aquaticum一致性均>99%。细菌基因组高通量测序,发现本例临床分离株与Genbank数据库中Herbaspirillum huttiense subsp putei IAM 15032同源性为100%,证实本例分离株为Herbaspirillum huttiense。结论环境微生物演变成人类病原菌种类不断增多,草螺菌属因其生化特性与其他菌种相似,极易被误鉴定,需引起检验工作者的重视。Objective To analyze the identification and antibiotics susceptibility of Herbaspirillum in catheter-related bloodstream infection,and improve the awareness and attention of the rare pathogenic microorganisms for clinicians and microbiologists.Methods The bacterium was isolated from a positive blood culture of a hemodialysis patient with chronic renal failure.The smear of isolate was prepared,stained and observed by microscope.The single colonies were identified by mass spectrometry and VITEK 2 Compact identification and antibiotics sensitivity analysis system,respectively.Then,16S ribosomal DNA(rDNA)was amplified and sequenced,and bacterial genome was sequenced.Results The gram-negative bacilli was found in the positive blood culture bottle.After incubated on blood agar for 16 hours,milky white,bulging and non-haemolytic colonies were observed.The identification result was Burkholderia cepacian by VITEK 2_Compact and antimicrobial susceptibility testing showed resistance to aztreonam and polymyxin but sensitive to other drugs in N335 card.The isolate could not be identified by VITEK MS with clinical database.However,it was identified as Herbaspirillum huttiense/Herbaspirillum aquaticum with research database.The 16S rDNA of the strain was consistent with Herbaspirillum huttiense and Herbaspirillum aquaticum(more than 99%).High-throughput bacterial genome sequencing revealed that the isolate in this case shared 100%homology with Herbaspirillum huttiense subsp putei IAM 15032 in Genbank database,which confirmed that the isolate was Herbaspirillum huttiense.Conclusions There are more and more environmental microorganisms evolved into human pathogenic bacteria.Herbaspirillum species are easy to be misidentified because its biochemical characteristics are similar to other strains.

关 键 词：导管相关性感染 菌血症 草螺菌属 基因组 细菌 高通量核苷酸序列分析 微生物敏感性试验 

分 类 号：R446.5[医药卫生—诊断学] R692.5[医药卫生—临床医学]