纹带棒状杆菌引起肺部感染1例

目的 痰培养经传统生化鉴定及16S rRNA基因序列分析明确导致肺部感染的病原菌,据此建立相应抗感染的有效治疗方案。方法 对痰液培养中分离得到的菌株进行16S rRNA基因序列分析鉴定以及传统的革兰染色、生化反应鉴定。采用纸片扩散法( K-B 法) 进行药敏试验。结果 16S rRNA基因序列分析鉴定结果显示分离株与纹带棒状杆菌有99％同源（GenBank编号：JF342700.1）,使用VITEK 2-Compact 全自动细菌鉴定仪及与其相匹配的VITEK 2 ANC棒状杆菌鉴定（产品代码21348）卡鉴定结果也符合纹带棒状杆菌的特征（鉴定率：99.9%）,正式报告致病菌为纹带棒状杆菌。药敏结果显示该菌对利奈唑胺、阿米卡星、万古霉素敏感。明确病原菌为纹带棒状杆菌后,迅速调整抗生素治疗方案为静点利奈唑胺,8 d后患者肺部感染情况逐渐好转,各项实验室检查结果大部分在正常范围,且炎症指标也降落至参考范围之内,遂出院回家休养。结论 临床微生物工作者以及临床医生应该重视纹带棒状杆菌引起的感染,及早为患者建立有效的抗感染治疗方案。

A case of community-acquired pneumonia due to Corynebacterium striatum

Objective The pathogenic bacteria of lung infection isolated from sputum culture was identified by traditional biochemical identification and 16S rRNA gene sequence analysis in order to establish the effective treatment of anti-infection immediately. Methods The 16S rRNA gene sequence analysis and traditional biochemical reactions were used for identification of the strains isolated from sputum culture. The susceptibility to antimicrobials was tested by Kirby-Bauerdisk diffusion method. Results The gene (16S rRNA) sequencing result showed that the causative agent belonged to Corynebacterium striatum (GenBank: JF342700.1, 99%) on GenBank databases. Conventional biochemical and culture phenotypic characterization were also consistent with Corynebacterium striatum. The stain was also identified by the VITEK® 2 Compact and VITEK 2 ANC Identification Card (Production code:21348) as Corynebacterium striatum (identification rate was 99.9%). Antimicrobial susceptibility test showed that the strain was sensitive to linezolid, Amikacin and vancomycin. Then we adjusted the therapeutic regimen: Intravenous injection of linezolid. After 8 days of treatment, the patient's lung infection gradually improved, most of the laboratory results were in the normal range, and the index of inflammation was also within the normal reference range, and then returned home to rest. Conclusion Clinical microbiologist and clinicians should pay attention to infection caused by Corynebacterium striatum in order to establish effective anti-infective treatment for patients.