达卡气单胞菌血流感染1例报道  

A case report of Aeromonas dhakensis bloodstream infection

作　　者：周显元 黄颖凤 贾阿韶 俞梦秋 邓莉 ZHOU Xianyuan;HUANG Yingfeng;JIA Ashao;YU Mengqiu;DENG Li(Department of Laboratory Medicine,Shenzhen University General Hospital,Shenzhen 518055,Guangdong Province,China)

机构地区：[1]深圳大学总医院检验科,广东深圳518055

出　　处：《微生物与感染》2024年第4期232-236,共5页Journal of Microbes and Infections

摘　　要：达卡气单胞菌(Aeromonas dhakensis)血流感染的相关报道较少,本文报告了1例肝硬化患者并发达卡气单胞菌血流感染的病例,患者出现发热、蜂窝织炎、坏死性筋膜炎、横纹肌溶解及类似坏疽性深脓疱,并发生脓毒性休克,其疾病进展非常迅速,预后不良。在菌种鉴定过程中,梅里埃VITEK 2 Compact将此菌株鉴定为嗜水气单胞菌/豚鼠气单胞菌、布鲁克质谱仪将其鉴定为嗜水气单胞菌(属内蛋白指纹图谱接近,与其他种不能区分)、16S rRNA测序未能明确区分菌种,这3种方法均未能准确地鉴定,gyrB测序、宏基因组二代测序(metagenomic next-generation sequencing,mNGS)可以得出明确的菌种结果。本文通过综合应用多种鉴定方法为临床提供了一个明确的鉴定结果,为快速精准治疗提供依据。There are few reports on bloodstream infections caused by Aeromonas dhakensis.This article presented a case report of a patient with liver cirrhosis who developed Aeromonas dhakensis bloodstream infection.The patient exhibited symptoms such as fever,cellulitis,necrotizing fasciitis,rhabdomyolysis,and lesions resembling pyoderma gangrenosum,and suffered septic shock.The disease progressed rapidly with a poor prognosis.During the species identification process,methods such as the bioMérieux VITEK 2 Compact identified the isolate as either Aeromonas hydrophila or Aeromonas caviae.The Bruker mass spectrometer identified it as Aeromonas hydrophila,noting that the intragenus protein fingerprint was similar and could not be differentiated from other species.Additionally,16S rRNA sequencing failed to unequivocally distinguish the species.All these methods including the bioMérieux VITEK 2 Compact,Bruker mass spectrometer,and 16S rRNA sequencing were unable to provide accurate identification.However,gyrB sequencing and metagenomic next-generation sequencing(mNGS)were able to yield definitive species results.Through the comprehensive application of multiple methods,this study provides a clear identification result for clinical diagnosis.

关 键 词：达卡气单胞菌 血流感染 gyrB测序 

分 类 号：R466[医药卫生—临床医学]