植生拉乌尔菌致血流感染并中枢神经系统感染1例并文献复习  

Bloodstream and central nervous system infection caused by Raoultella planticola:one case report and literature review

作　　者：潘娟 吴俊 叶超 钟菁[1] 聂格 张旭 李足意 周玲芝[1] 李晨 王春江[5] PAN Juan;WU Jun;YE Chao;ZHONG Jing;NIE Ge;ZHANG Xu;LI Zuyi;ZHOU Lingzhi;LI Chen;WANG Chunjiang(Department of Pharmacy,Liuyang Hospital of Traditional Chinese Medicine,Liuyang Hunan 410300,China)

机构地区：[1]浏阳市中医医院药学部,湖南浏阳410300 [2]浏阳市中医医院肿瘤血液病科,湖南浏阳410300 [3]长沙市第三医院药学部 [4]浏阳市中医医院检验科,湖南浏阳410300 [5]中南大学湘雅三医院药学部

出　　处：《中国感染与化疗杂志》2022年第5期583-588,共6页Chinese Journal of Infection and Chemotherapy

摘　　要：目的分析植生拉乌尔菌感染的临床特征、诊断及治疗,以期提高对该病的认识。方法回顾性分析1例植生拉乌尔菌致血流感染并中枢神经系统感染患者的临床资料,以“植生拉乌尔菌”为主题词检索万方、维普和中国知网数据库,以“Raoultella planticola”为主题词检索PubMed数据库,检索时间截至2021年6月30日。结合收集的国内外发表的植生拉乌尔菌感染的文献报道,分析发生该病原菌感染的易感因素、感染部位、临床特征、治疗及预后。结果该例患者为41岁中年男性,患有胸腺神经内分泌瘤(正在接受化疗)、2型糖尿病、4个月前曾行埋入式椎管内镇痛药物输注港植入术,以发热为主要临床特征,血培养和脑脊液培养均提示“植生拉乌尔菌”生长,经美罗培南、头孢曲松抗感染治疗,体温恢复正常,复查脑脊液培养未见该菌再生长。植生拉乌尔菌感染患者男性多于女性,各年龄段均可受影响,文献报道的67例患者平均年龄53岁(1月龄~92岁),多有基础疾病或相关诱因。植生拉乌尔菌感染可累及全身各部位。抗菌药物治疗以β内酰胺类为主,占80.6%(54/67)。总体预后良好,治愈率达88.1%(59/67)。结论植生拉乌尔菌感染易发生于免疫功能低下患者,对大多数抗菌药物敏感,治疗后预后较好。Objective To review the clinical characteristics,diagnosis and treatment of infections caused by Raoultella planticola for better understanding of the disease.Methods One case of bloodstream and central nervous system infection caused by R.planticola was reported in a male patient.The relevant reports of R.planticola infection published in China and abroad were searched in PubMed,Wanfang,VIP,and China National Knowledge Infrastructure(CNKI)databases with search term“Raoultella planticola”from the inception of each database up to June 30,2021 to summarize the predisposing factors,site of infection,clinical manifestations,treatment and outcome.Results The patient was a 41-year-old male with neuroendocrine tumor of the thymus(undergoing chemotherapy)and type 2 diabetes.Four months ago,the patient underwent implantation of the implantable intraspinal analgesic drug infusion port.Fever was the main clinical manifestation.Both blood culture and cerebrospinal fluid culture suggested the growth of R.planticola.Meropenem and ceftriaxone treatment made the body temperature return to normal.Regrowth of the bacterium was not observed in cerebrospinal fluid culture.Analysis of the 67 cases of R.planticola infections indicates that the infections caused by R.planticola are more common in men than in women.Individuals are susceptible to R.planticola infection at any age.The average age of the 67 patients was 53 years old(range 1 month-92 years old).Most of the patients had underlying disease or triggers.R.planticola infection could involve any part of the body.Beta-lactam antimicrobial agents were used to treat R.planticola infection in 80.6%(54/67)of the cases.The overall clinical cure rate was 88.1%(59/67).Conclusions Immunocompromised individuals are susceptible to R.planticola infection.Most antimicrobial agents are active against R.planticola isolates and generally result in good treatment outcome.

关 键 词：植生拉乌尔菌 血流感染 中枢神经系统感染 

分 类 号：R515.3[医药卫生—内科学]