一例由结核硬脂酸棒状杆菌引起的感染及实验室对不常见细菌的应对策略  

An infection caused by Corynebacterium tuberculum and laboratory response to uncommon bacteria

作　　者：刘景武[1] 张蕊[1] 崔伟波 孙文泽[1] 董佳[1] 任天红[1] LIU Jing-wu;ZHANG Rui;CUI Wei-bo;SUN Wen-ze;DONG Jia;REN Tian-hong(Clinical Laboratory,the Third Hospital of Shijiazhuang,Shijiazhuang,Hebei 050001,China)

机构地区：[1]河北省石家庄市第三医院检验科,河北石家庄050001

出　　处：《中国卫生检验杂志》2020年第20期2473-2474,2481,共3页Chinese Journal of Health Laboratory Technology

摘　　要：目的本文报道了一例罕见的由结核硬脂酸棒状杆菌引起的皮肤软组织感染,以及实验室在分离培养后的应对策略,尽可能的减少漏检染的发生。方法收集了2018年9月由于腋前红肿在本院外科门诊就诊的患者一例。诊断为腋前肿物继发感染,抽取右侧脓液进行微生物培养。结果培养物为革兰阳性棒状杆菌,使用全自动快速微生物质谱检测系统鉴定结果为结核硬脂酸棒状杆菌。药敏试验结果显示,万古霉素、替考拉宁、青霉素、美罗培南、亚胺培南等均为敏感,红霉素、克林霉素等为耐药。结论本文证实为一例由结核硬脂酸棒状杆菌引起的感染。革兰阳性棒状杆菌引起的感染在逐年增加,应引起足够的重视,而由结核硬脂酸棒状杆菌引起的感染目前比较罕见。在对一些罕见未知菌进行鉴定时,一些先进检测手段如飞行质谱、分子手段可以提供准确的鉴定结果。Objective A rare case of skin and soft tissue infection caused by Corynebacterium tuberculostearicum was reported,and the strategies for laboratory isolation and culture were prepared to minimize the occurrence of missed detection.Methods In September,2018,we collected one case of patients who visited the surgical department of our hospital due to anterior axillary redness and swelling.Diagnosis showed anterior axillary mass secondary infection,and right pus was extracted for microbial culture.Results The culture was Corynebacterium,gram-positive,and the results were identified as Corynebacterium tuberculosis stearate by automatic rapid microbial mass spectrometry.The results showed that vancomycin,tikoranin,penicillin,meropenem and imipenem were all sensitive,while erythromycin and clindamycin were resistant.Conclusion This article confirmed a case of infection caused by Corynebacterium tuberculostearicum.The infections caused by Corynebacterium gram-positive are increasing year by year,which should be paid enough attention to.However,the infections caused by Corynebacterium tuberculostearicum are relatively rare at present.When identifying some rare and unknown bacteria,some advanced detection methods such as flight mass spectrometry and molecular methods can provide accurate identification results.

关 键 词：结核硬脂酸棒状杆菌 感染 鉴定 飞行质谱 

分 类 号：R446.5[医药卫生—诊断学]