PDF(Pubmed)
Abstract：
Necrotizing fasciitis is a type of necrotizing soft tissue infection (NSTI) that can be polymicrobial or monomicrobial in origin. Polymicrobial infections typically involve anaerobes of the Clostridium or Bacteroides family. This case report highlights necrotizing fasciitis caused by an unusual culprit, Actinomyces europaeus, which is a gram-positive anaerobic filamentous bacillus that has only been documented in one prior report to cause NSTI. Currently, about half of the hospitals in the United States are equipped to perform antibiotic susceptibility testing for anaerobes, but less than one-quarter of hospitals actually utilize these tests routinely. Thus, it is common for polymicrobial actinomycoses to be blindly treated with antibiotics that are beta-lactamase resistant and active against anaerobes, such as with piperacillin-tazobactam. Here we examine the potential impact of this lack of testing, as well as the evolution of A. europaeus to cause necrotizing fasciitis.
摘要：
坏死性筋膜炎是一种坏死性软组织感染（NSTI），可以是多微生物或单抗微生物的。多微生物感染通常涉及梭状芽孢杆菌或拟杆菌家族的厌氧菌。此病例报告强调了由不寻常的罪魁祸首引起的坏死性筋膜炎，欧洲放线菌，这是一种革兰氏阳性厌氧丝状杆菌，仅在以前的一份报告中记录过，导致NSTI。目前,美国大约一半的医院都配备了对厌氧菌进行抗生素敏感性测试，但是只有不到四分之一的医院经常使用这些测试。因此，常见的是，用β-内酰胺酶抗性和对厌氧菌有活性的抗生素盲目治疗微生物放线菌，如哌拉西林他唑巴坦。在这里，我们研究这种缺乏测试的潜在影响，以及引起坏死性筋膜炎的欧洲曲霉菌的演变。
