1例索氏梭杆菌感染引起的气性坏疽检验解析  

Detection and analysis of a case of gas gangrene caused by Clostridium soxhlet infection

作　　者：汤卓琼 李宇宁[1] 江琰笛[1] 郑庆斌 TANG Zhuo-qiong;LI Yu-ning;JIANG Yan-di;ZHENG Qing-bin(Ningbo Sixth Hospital,Ningbo,Zhejiang 315040,China)

机构地区：[1]浙江省宁波市第六医院,浙江宁波315040 [2]浙江省宁波市海曙第三医院,浙江宁波315171

出　　处：《中国卫生检验杂志》2021年第21期2648-2650,共3页Chinese Journal of Health Laboratory Technology

摘　　要：目的 本文报道了1例罕见的由索氏梭杆菌引起的气性坏疽,以及实验室在分离培养后的应对策略,尽可能减少漏检率。方法 收集2019年8月由于拆除内固定在本院骨科门诊就诊的患者1例。诊断为拆内固定术后条件致病菌感染,抽取分泌物进行微生物培养。结果 培养物为粗大革兰阳性杆菌,使用全自动快速微生物质谱检测系统鉴定结果为索氏梭杆菌。药敏试验结果显示,青霉素G、阿莫西林、哌拉西林、阿莫西林/克拉维酸、替卡西林/克拉维酸,哌拉西林/他唑他坦、头孢西丁、头孢替坦、亚胺培南、克林霉素、甲硝唑、氯霉素均为敏感。结论 本文证实为1例由索氏梭杆菌引起的感染。气性坏疽是由厌氧梭状芽胞杆菌引起的一种罕见暴发性坏死性感染,若治疗不及时,病死率可达100%。因此早期诊断和积极治疗至关重要。对罕见未知菌进行鉴定时,一些先进检测手段如飞行质谱等可提供准确的鉴定结果。Objective This paper reports a rare case of gas gangrene caused by Clostridium soxhlet and the countermeasures after isolation and culture in laboratory,so as to reduce the rate of missed detection as much as possible.Methods A case of orthopedic patient who was admitted to the outpatient department of our hospital in August 2019 due to removal of internal fixation was collected..It was diagnosed as conditional pathogenic infection after internal fixation,and the secretions were extracted for microbial culture.Results The culture was Coarse gram-positive bacilli,which was identified as Clostridium soxhlet by automatic rapid microbiological mass spectrometry.Drug sensitivity test results showed that it was all sensitive to penicillin G,amoxicillin,piperacillin,amoxicillin/clavulanic acid,ticacillin/clavulanic acid,piperacillin/tazotactam,cefoxitin,cefbtetan,imipenem,clindamycin,metronidazole and chloramphenicol.Conclusion A case of infection caused by Clostridium soxhlet was confirmed.Gas gangrene is a rare fulminant necrotizing infection caused by Clostridium artaerobicum.If the treatment is not timely,the case fatality rate can reach 100%.Therefore,early diagnosis and active treatment are very important.Some advanced detection methods,such as flight mass spectrometry,can provide accurate identification results when identifying rare and unknown bacteria.

关 键 词：索氏梭杆菌 气性坏疽 厌氧菌 

分 类 号：R446.5[医药卫生—诊断学]