PDF(Pubmed)
Abstract：
A 39-year-old woman with a 3-year human papillomavirus (HPV) 18 infection history was admitted to the hospital for a 16-day history of vaginal bleeding after sex. She was diagnosed with cervical cancer based on the results of the electronic colposcopy, cervical cytology, microscopy, and magnetic resonance imaging (MRI). Then, she received chemotherapy, with paclitaxel 200 mg (day 1), cisplatin 75 mg (day 2), and bevacizumab 700 mg (day 3) twice with an interval of 27 days. During the examination for the diagnosis and treatment, many invasive operations, including removal of intrauterine device, colposcopy, and ureteral dilatation, were done. After that, the patient was discharged and entered the emergency department about 2.5 months later with a loss of consciousness probably caused by septic shock. The patient finally died of multiple organ failure and bacterial infection, although she has received antimicrobial therapy. The blood cultures showed a monobacterial infection with an anaerobic Gram-positive bacterial strain, designated as SAHP1. Matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) indicated that the patient was infected with Peptoniphilus asaccharolyticus, while molecular analysis and genome-based taxonomy confirmed the infection with a novel Peptoniphilus species that has a close genetic relationship with Peptoniphilus vaginalis and proposed provisionally as Peptoniphilus septimus sp. nov., which may also act as a commensal of the human vagina. Genomic features of SAHP1 have been fully described, and comparative genomic analysis reveals the known prokaryote relative of Peptoniphilus septimus sp. nov. in the genus Peptoniphilus. The invasive operations on the genital tract during the diagnosis and treatment of the patient and the tumor tissue damage and bleeding may have a certain role in the bloodstream infection. This study casts a new light on the Peptoniphilus bacteria and prompts clinicians to include anaerobic blood cultures as part of their blood culture procedures, especially on patients with genital tract tumors. Furthermore, due to the incomplete database and unsatisfying resolution of the MALDI-TOF MS for Peptoniphilus species identification, molecular identification, especially whole-genome sequencing, is required for those initially identified as bacteria belonging to Peptoniphilus in the clinical laboratory.
摘要：
一名具有3年人乳头瘤病毒（HPV）18感染史的39岁女性因性交后阴道出血16天病史入院。根据电子阴道镜检查的结果，她被诊断出患有宫颈癌，宫颈细胞学,显微镜,磁共振成像（MRI）。然后，她接受了化疗,紫杉醇200毫克（第1天），顺铂75毫克（第2天），和贝伐单抗700mg（第3天）两次，间隔27天。在诊断和治疗的检查过程中，许多侵入性手术，包括取出宫内节育器,阴道镜检查,输尿管扩张,已完成。之后,患者出院,约2.5个月后进入急诊科,可能是由感染性休克引起的意识丧失.患者最终死于多器官功能衰竭和细菌感染，尽管她已经接受了抗菌治疗。血液培养显示厌氧革兰氏阳性细菌菌株的单细菌感染，指定为SAHP1。基质辅助激光解吸电离飞行时间质谱（MALDI-TOFMS）显示该患者感染了阿糖胞苷，而分子分析和基于基因组的分类学证实了一种新型的Peptoniphilus物种的感染，该物种与阴道Peptoniphilus具有密切的遗传关系，并被临时提议为Peptoniphilusseptimussp。11月。,它也可以作为人类阴道的共生体。SAHP1的基因组特征已得到充分描述，和比较基因组分析揭示了Peptoniphilusseptimussp的已知原核生物亲戚。11月。在Peptoniphilus属中。在诊断和治疗过程中对生殖道的侵入性操作以及肿瘤组织的损伤和出血可能对血流感染有一定的作用。这项研究为Peptoniphilus细菌提供了新的思路，并提示临床医生将厌氧血培养物作为血液培养程序的一部分。尤其是生殖道肿瘤患者。此外，由于Peptoniphilus物种鉴定的MALDI-TOFMS的数据库不完整和分辨率不令人满意，分子鉴定，尤其是全基因组测序，对于在临床实验室中最初鉴定为属于Peptoniphilus的细菌的细菌是必需的。
