Nadir bir katetere bağlı bakteriyemi etkeni:Rhizobium radiobacter
Küçük Resim Yok
Tarih
2008
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Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Rhizobium türleri (R.radiobacter, R.rhizogenes, R.rubi, R.vitis) aerobik, hareketli, spor oluşturmayan, oksidâz pozitif, gram-negatif basillerdir. Çoğu kez bitki patojeni olmalarına rağmen R.radiobacter insanlarda enfeksiyona neden olabilir. Bu makalede levofloksasin ile tedavi edilen R. radiobacter bakteriyemili bir olgu sunulmuştur. Osteosarkom tanısı ile kemoterapi verilen 27 yaşındaki erkek hastada ateş yüksekliği nedeniyle yapılan fizik muayenede enfeksiyon odağı saptanamamış, periferik venden ve santral kateterden kan kültürleri alınarak hastaya ampirik levofloksasin (500 mg/gün) tedavisi başlanmıştır. Bir gün sonra hastanın ateşi düşmüştür. Bu arada hastanın hem santral kateterinden hem de periferik yenlerinden alınan kan kültürlerinde (Bact/Alert otomatize sistemi, bioMerieux, Durham, NC) üreyen bakteri VITEK 2 otomatize sistemi (bioMerieux İne, Mercy L'etoil, Fransa) ile R.radiobacter olarak tanımlanmıştır. İzolatın, amikasine dirençli; seftazidim, siprofioksasin, imipenem, meropenem ve piperasilin/tazobaktama duyarlı olduğu saptanmıştır. Kateter ile ilişkili bakteriyemi olgusu olarak değerlendirilen hastanın tedavisi levofloksasin ile sürdürülmüştür. Hastanın daha sonra alınan kan ve kateter kanı kültürlerinde üreme saptanmadığı için kateteri çekilmemiştir. Klinik olarak tedaviye yanıt alınan olgunun antibiyotik tedavisi 14 güne tamamlanmıştır. Sonuç olarak bu olgu özellikle kateter ya da protez kapak gibi yabancı cisim bulunan bağışıklık sistemi baskılanmış hastalarda R.radiobactertrı enfeksiyona neden olabileceğini düşündürmektedir. Olgumuz bildiğimiz kadarıyla Türkiye'den bildirilen ilk R.radiobacter bakteriyemisi olgusu olup, ayrıca literatürde levofloksasin ile tedavi edildiği rapor edilen ilk olgudur.
Rhizobium spp. (R.radiobacter, R.rhizogenes, R.rubi, R.vitis) are aerobic, motile, non-spore forming, oxidase-positive, gram-negative bacilli. Although they are mostly plant pathogens, R.radiobacter may cause human infections. The aim of this report was to present a case of R.radiobacter bacteremia treated with levofloxacin. Twenty-seven year old male patient had fever after receiving chemotherapy due to osteosarcoma. The infection focus could not be detected in the initial physical examination. Blood cultures were obtained from peripheral veins and central catheter and levofloxacin (500 mg/day) was started as empirical therapy. His fever resolved on the next day. Meanwhile cultures of blood (Bact/Alert automated systems, bioMerieux, Durham, NC) obtained from peripheral veins and central catheters yielded bacteria which were identified as R.radiobacter by VITEK 2 (bioMerieux Inc, Mercy L'etoil, France). The strain was resistant to amikacin and sensitive to ceftazidime, ciprofloxacin, imipenem, meropenem and piperacillin/tazobactam. The patient was diagnosed as catheter-related bacteremia and the treatment was continued for 14 days. His catheter was not removed since subsequent cultures did not reveal any bacterial growth. In conclusion this case suggests that R.radiobacter may cause infections especially in immunocompromised patients with catheters or prosthetic devices. To our knowledge this is the first R.radiobacter case reported from Turkey and the first case of R.radiobacter bacteremia reported to be treated with levofloxacin in the literature.
Rhizobium spp. (R.radiobacter, R.rhizogenes, R.rubi, R.vitis) are aerobic, motile, non-spore forming, oxidase-positive, gram-negative bacilli. Although they are mostly plant pathogens, R.radiobacter may cause human infections. The aim of this report was to present a case of R.radiobacter bacteremia treated with levofloxacin. Twenty-seven year old male patient had fever after receiving chemotherapy due to osteosarcoma. The infection focus could not be detected in the initial physical examination. Blood cultures were obtained from peripheral veins and central catheter and levofloxacin (500 mg/day) was started as empirical therapy. His fever resolved on the next day. Meanwhile cultures of blood (Bact/Alert automated systems, bioMerieux, Durham, NC) obtained from peripheral veins and central catheters yielded bacteria which were identified as R.radiobacter by VITEK 2 (bioMerieux Inc, Mercy L'etoil, France). The strain was resistant to amikacin and sensitive to ceftazidime, ciprofloxacin, imipenem, meropenem and piperacillin/tazobactam. The patient was diagnosed as catheter-related bacteremia and the treatment was continued for 14 days. His catheter was not removed since subsequent cultures did not reveal any bacterial growth. In conclusion this case suggests that R.radiobacter may cause infections especially in immunocompromised patients with catheters or prosthetic devices. To our knowledge this is the first R.radiobacter case reported from Turkey and the first case of R.radiobacter bacteremia reported to be treated with levofloxacin in the literature.
Açıklama
Anahtar Kelimeler
Mikrobiyoloji
Kaynak
Mikrobiyoloji Bülteni
WoS Q Değeri
Scopus Q Değeri
Cilt
42
Sayı
2
