PDF(Pubmed)
Abstract：
Pantoea, a gram-negative, rod-shaped, anaerobic bacterium, is a rare cause of human disease. Pantoea species have been known to mostly cause pulmonary disease in agricultural workers as they are native to select crops and wild animal furs. However, in very few documented cases, Pantoea has been discovered as the source of nosocomial infections, usually in the setting of an immunocompromised host. This case report details the clinical course of a 62-year-old immunocompromised female with stage 3 breast cancer presenting with acute cholecystitis and bacteremia and the unexpected discovery of Pantoea in peripheral and chemotherapy port blood cultures. After appropriate management and susceptibility testing, the patient fortunately recovered with initial cefepime and eventual levofloxacin to target the Pantoea species. To our knowledge, this is the third documented case worldwide of Pantoea isolated from cholecystitis with associated bacteremia and the first documented case in North America. Of special interest, a few months after her infection, the patient was found to be free of breast cancer. Pantoea species are known to contain levan, an exopolysaccharide, that has been seen to upregulate tumor suppressor genes. This should be considered in the future management and research of Pantoea infections.
摘要：
泛菌,革兰氏阴性，杆状,厌氧细菌，是人类疾病的罕见原因。已知泛菌物种主要在农业工人中引起肺部疾病，因为它们是选择农作物和野生动物毛皮的本地物种。然而,在极少数有记录的案例中，泛菌已被发现是医院感染的来源，通常在免疫受损宿主的环境中。该病例报告详细介绍了一名62岁的免疫功能低下的女性的临床过程，该女性患有3期乳腺癌，伴有急性胆囊炎和菌血症，并在外周和化疗端口血培养中意外发现了Pantoea。经过适当的管理和敏感性测试，幸运的是，患者最初使用头孢吡肟和最终的左氧氟沙星以Pantoea物种为目标而康复。据我们所知,这是全球范围内第3例从胆囊炎中分离出的Pantoea伴相关菌血症病例,也是北美第1例病例.特别感兴趣的是，在她感染几个月后,该患者被发现没有乳腺癌。已知泛菌物种含有果聚糖，胞外多糖，已经被认为上调了肿瘤抑制基因。在未来的泛菌感染管理和研究中应考虑这一点。
