PDF(Pubmed)
Abstract：
Cedecea lapagei is a gram-negative, non-encapsulated, facultative anaerobic bacterium that has been reported in only a few cases with varying clinical presentations, drug susceptibility, and treatment since its first isolation in 1981. This study aimed to describe a case report of C. lapagei in Peru and systematically review the documented case reports of individuals infected with C. lapagei. A 59-year-old man who had become bedridden with Parkinson\'s disease and had epilepsy presented with a 1-week history of fever and sore throat and was admitted. Physical examination revealed an obtundation state and abolished vesicular murmur in the right hemithorax. During hospitalization, the patient was diagnosed with various infections, including tuberculosis, for which he received broad-spectrum antibiotics. In the absence of clinical improvement, a urine culture was performed showing C. lapagei (detected by BD Phoenix M50 system, Vernon Hills, IL). The patient received amoxicillin/clavulanate and was discharged. Case reports of C. lapagei were also searched in five databases on January 28, 2023. Twenty cases of C. lapagei were reported worldwide between 2006 and 2022, 16 of which involved adults. Fever was the most common manifestation (75%), and pneumonia was the primary form of presentation (45%). Moreover, 90% of the patients had at least one comorbidity, and 15% died. Also, most of the isolates were sensitive to ciprofloxacin (81%), meropenem (62%), and amikacin (60%). Overall, C. lapagei should be suspected in compromised hosts, particularly those with pneumonia. Although the bacterium can affect various organs and the antibiotic susceptibility pattern is variable, quinolones, tetracyclines, and carbapenems seem to be the first therapeutic option.
摘要：
拉皮雪花是革兰氏阴性的,非封装，兼性厌氧细菌，仅在少数具有不同临床表现的病例中报道，药物敏感性,和自1981年首次隔离以来的治疗。本研究旨在描述秘鲁拉帕吉氏杆菌的病例报告，并系统地回顾已记录的感染拉帕吉氏杆菌的个体的病例报告。一名59岁的男子因帕金森氏病卧床不起，患有癫痫，有1周的发烧和喉咙痛病史，因此入院。体格检查显示右半胸部呈迟钝状态，并消除了膀胱杂音。住院期间,病人被诊断患有各种感染，包括肺结核,为此他接受了广谱抗生素。在没有临床改善的情况下，进行尿液培养，显示拉皮梭菌(通过BDPhoenixM50系统检测，VernonHills,IL).患者接受阿莫西林/克拉维酸治疗后出院。2023年1月28日，还在五个数据库中搜索了拉帕吉氏杆菌的病例报告。在2006年至2022年期间，全球报告了20例拉皮梭菌，其中16例涉及成年人。发烧是最常见的表现（75％），肺炎是主要的表现形式(45%).此外，90%的患者有至少一种合并症,15%的人死亡。此外，大多数分离株对环丙沙星敏感(81%)，美罗培南（62%），和阿米卡星（60%）。总的来说,C.lapagei应该在受损主机中被怀疑，尤其是肺炎患者。尽管细菌可以影响各种器官，并且抗生素敏感性模式是可变的，喹诺酮类药物,四环素,碳青霉烯类似乎是第一种治疗选择。
