化脓性链球菌emm22基因型伴有CsrS突变的STSS:病例报告。

IF 1.3 4区 医学 Q4 INFECTIOUS DISEASES
Japanese journal of infectious diseases Pub Date : 2024-11-21 Epub Date: 2024-02-29 DOI:10.7883/yoken.JJID.2023.332
Kaoru Ogawa, Jiro Kamiyama, Tadayoshi Ikebe, Shigemasa Taguchi, Kazuya Kiyota
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引用次数: 0

摘要

患者是一名 22 岁的女性,无任何并发症,因心脏骤停转入我院。在到达医院之前,治疗使患者恢复了自主循环。在医院,患者的生命体征不稳定。医生为其注射了血管加压药并进行了高补液治疗。计算机断层扫描(CT)显示,没有导致心脏骤停的明显变化。在进行血液培养检查后,医生为患者开具了抗生素处方。患者被送入重症监护室。在重症监护室,继续使用大容量血管加压药、高补液疗法和输注新鲜冰冻血浆。血液培养检查两小时后,结果仍为阳性。革兰氏染色显示为链球菌,抗生素改为青霉素 G 钾、克林霉素,并添加了免疫球蛋白。高补液疗法导致呼吸衰竭。入住重症监护室 10 小时后,开始使用体外膜氧合,但患者的一般状况没有改善。患者在入院 40 小时后死亡。血液培养结果显示为化脓性链球菌;T 型和 M 型血清型无法分类。emm基因型为emm22。发热毒素基因方面,speA 和 speB 为阳性,speC 为阴性。在 CsrS、CsrR 和 Rgg 氨基酸序列中,检测到 CsrS 基因突变。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Streptococcal Toxic Shock Syndrome Caused by a Streptococcus pyogenes emm22 Genotype with a CsrS Mutation: a Case Report.

A previously healthy 22-year-old woman was admitted to our hospital after an out-of-hospital cardiac arrest. Spontaneous circulation was restored prior to arrival at the hospital. However, the patient's vital signs remained unstable. Vasopressors and hyperhydration therapy were administered. Computed tomography did not reveal a cause of the cardiac arrest. Antibiotics were initiated after obtaining blood culture samples. The patient was admitted to the intensive care unit (ICU). High-dose vasopressors and hyperhydration therapy were continued and fresh frozen plasma was transfused. Two hours after ICU admission, gram staining of a blood smear revealed the presence of Streptococcus, and the antibiotics were switched to penicillin G potassium and clindamycin, and immunoglobulins were administered. Extracorporeal membrane oxygenation was initiated 10 h after ICU admission owing to respiratory failure caused by fluid overload; however, the patient's condition did not improve and she died 40 h after admission. Blood culture results confirmed the presence of Streptococcus pyogenes; the T and M serotypes were unclassifiable. The emm genotype was emm22. Sequencing revealed the presence of streptococcal pyrogenic toxin genes, speA and speB, whereas speC was absent. CsrS, CsrR, and Rgg amino acid sequencing revealed the presence of a CsrS mutation.

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来源期刊
CiteScore
4.50
自引率
4.50%
发文量
172
审稿时长
2 months
期刊介绍: Japanese Journal of Infectious Diseases (JJID), an official bimonthly publication of National Institute of Infectious Diseases, Japan, publishes papers dealing with basic research on infectious diseases relevant to humans in the fields of bacteriology, virology, mycology, parasitology, medical entomology, vaccinology, and toxinology. Pathology, immunology, biochemistry, and blood safety related to microbial pathogens are among the fields covered. Sections include: original papers, short communications, epidemiological reports, methods, laboratory and epidemiology communications, letters to the editor, and reviews.
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