PDF(Pubmed)
Abstract：
BACKGROUND: Comamonas kerstersii mainly causes intra-abdominal infections with favorable outcomes due to high antibiotic susceptibility. We report the first case of pneumonia caused by C Kerstersii, which promoted patient death, and a second urinary tract infection by C Kerstersii with extensive drug resistance.
METHODS: A 46-year-old male (Case 1) with craniocerebral injury underwent emergency decompressive craniectomy, but his condition deteriorated further and presented with discontinuous fever, small moist rales on both lungs, and respiratory failure. Retrospective average nucleotide identity (ANI) analysis of the genomic sequence of the sputum isolate identified it as C Kerstersii 12322-1, antimicrobial susceptibility testing (AST) revealed that it was sensitive to 18 of 21 tested antibiotics.An 82-year-old male (Case 2) with hypertrophic prostate experienced gradual obstruction during urination, and a urine test revealed WBC ++. Retrospective ANI analysis of the urine isolate identified it as C Kerstersii 121606, which was resistant to 18 of 21 tested antibiotics.
METHODS: Case 1 was diagnosed empirically as pneumonia caused by C Kerstersii strain 12322-1 secondary to craniocerebral injury and confirmed by retrospective ANI analysis; case 2 was diagnosed empirically as urinary infection secondary to prostate hyperplasia caused by C Kerstersii strain 121606 confirmed by the retrospective ANI analysis.
METHODS: Case 1 was administered cefoxitin, cefodizime, imipenem-cilastatin sodium, and underwent comprehensive salvage management. Case 2 was administered doxycycline alone.
RESULTS: Case 1 died partially because of untimely identification of the responsible bacteria-12322-1. Case 2 was cured even 121606 exhibited an extensive drug resistance feature.
CONCLUSIONS: Except for intra-abdominal infections with good prognosis, we verified that C Kerstersii could also cause extra-abdominal infections, such as the first pneumonia case and urinary infection. It could promote patient death; actual infections were underestimated due to identification difficulties, posing a health threat due to the presence of extensive drug resistance.
METHODS: A 46-year-old male (Case 1) with craniocerebral injury underwent emergency decompressive craniectomy, but his condition deteriorated further and presented with discontinuous fever, small moist rales on both lungs, and respiratory failure. Retrospective average nucleotide identity (ANI) analysis of the genomic sequence of the sputum isolate identified it as C Kerstersii 12322-1, antimicrobial susceptibility testing (AST) revealed that it was sensitive to 18 of 21 tested antibiotics.An 82-year-old male (Case 2) with hypertrophic prostate experienced gradual obstruction during urination, and a urine test revealed WBC ++. Retrospective ANI analysis of the urine isolate identified it as C Kerstersii 121606, which was resistant to 18 of 21 tested antibiotics.
METHODS: Case 1 was diagnosed empirically as pneumonia caused by C Kerstersii strain 12322-1 secondary to craniocerebral injury and confirmed by retrospective ANI analysis; case 2 was diagnosed empirically as urinary infection secondary to prostate hyperplasia caused by C Kerstersii strain 121606 confirmed by the retrospective ANI analysis.
METHODS: Case 1 was administered cefoxitin, cefodizime, imipenem-cilastatin sodium, and underwent comprehensive salvage management. Case 2 was administered doxycycline alone.
RESULTS: Case 1 died partially because of untimely identification of the responsible bacteria-12322-1. Case 2 was cured even 121606 exhibited an extensive drug resistance feature.
CONCLUSIONS: Except for intra-abdominal infections with good prognosis, we verified that C Kerstersii could also cause extra-abdominal infections, such as the first pneumonia case and urinary infection. It could promote patient death; actual infections were underestimated due to identification difficulties, posing a health threat due to the presence of extensive drug resistance.
摘要：
背景：由于对抗生素的敏感性较高，主要引起腹腔内感染，结果良好。我们报告了首例由CKerstersii引起的肺炎，促使病人死亡，并由CKerstersii引起第二次尿路感染，具有广泛的耐药性。
方法：一名46岁男性（病例1）颅脑损伤患者行紧急去骨瓣减压术，但他的病情进一步恶化，并出现不连续的发烧，两肺上有小的潮湿罗音，和呼吸衰竭。对痰液分离物基因组序列的回顾性平均核苷酸同一性（ANI）分析将其鉴定为CKerstersii12322-1，抗菌药物敏感性测试（AST）显示它对21种测试抗生素中的18种敏感。一名82岁男性（病例2）前列腺肥大在排尿过程中逐渐阻塞，尿检显示白细胞++。尿液分离物的回顾性ANI分析将其鉴定为CKerstersii121606，对21种测试抗生素中的18种具有抗性。
方法：病例1经经验诊断为颅脑损伤继发CKerstersii菌株12322-1所致肺炎，经回顾性ANI分析确诊；病例2经回顾性ANI分析确诊为CKerstersii菌株121606所致前列腺增生继发泌尿系感染。
方法：病例1服用头孢西丁，头孢地嗪,亚胺培南-西司他丁钠，并进行了全面的打捞管理。病例2单独给予多西环素。
结果：病例1部分死亡，原因是未及时鉴定出相关细菌-12322-1。病例2治愈甚至121606表现出广泛的耐药性特征。
结论：除腹腔内感染外，预后良好，我们证实了CKerstersii也可能引起腹外感染，如第一例肺炎病例和泌尿系感染。它可以促进患者死亡；由于识别困难，实际感染被低估了，由于存在广泛的耐药性，对健康构成威胁。
方法：一名46岁男性（病例1）颅脑损伤患者行紧急去骨瓣减压术，但他的病情进一步恶化，并出现不连续的发烧，两肺上有小的潮湿罗音，和呼吸衰竭。对痰液分离物基因组序列的回顾性平均核苷酸同一性（ANI）分析将其鉴定为CKerstersii12322-1，抗菌药物敏感性测试（AST）显示它对21种测试抗生素中的18种敏感。一名82岁男性（病例2）前列腺肥大在排尿过程中逐渐阻塞，尿检显示白细胞++。尿液分离物的回顾性ANI分析将其鉴定为CKerstersii121606，对21种测试抗生素中的18种具有抗性。
方法：病例1经经验诊断为颅脑损伤继发CKerstersii菌株12322-1所致肺炎，经回顾性ANI分析确诊；病例2经回顾性ANI分析确诊为CKerstersii菌株121606所致前列腺增生继发泌尿系感染。
方法：病例1服用头孢西丁，头孢地嗪,亚胺培南-西司他丁钠，并进行了全面的打捞管理。病例2单独给予多西环素。
结果：病例1部分死亡，原因是未及时鉴定出相关细菌-12322-1。病例2治愈甚至121606表现出广泛的耐药性特征。
结论：除腹腔内感染外，预后良好，我们证实了CKerstersii也可能引起腹外感染，如第一例肺炎病例和泌尿系感染。它可以促进患者死亡；由于识别困难，实际感染被低估了，由于存在广泛的耐药性，对健康构成威胁。
