由 Parabacteroides goldsteinii 引起的产妇产褥感染:一份病例报告

Liwei Peng, Xiaomin Chen, Zhenhui Wang, Lu Yi, Zhengjiang Jin
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引用次数: 0

摘要

金氏副乳菌(Parabacteroides goldsteinii)是副乳菌属的一员,最初是在阑尾炎、腹膜炎和腹腔脓肿患者的粪便和腹部组织中发现的。近年来,P. goldsteinii 被广泛认为是一种肠道益生菌,人类感染极为罕见。2010 年,首次从一名腹部感染患者的血液培养物中分离出金孢子菌,证实了其导致菌血症的能力。在本研究中,我们报告了一例罕见的产褥期感染病例,该病例是由孕妇感染金黄色葡萄球菌引起的脓毒性休克。一名 31 岁的女性在分娩过程中经历了会阴撕裂伤、宫颈撕裂伤和产后出血。产后九天,患者出现脓毒性休克,通过血液培养和质谱分析确定为金孢子菌感染。我们静脉注射了广谱抗生素,包括美罗培南/纳利昔酸和哌拉西林他唑巴坦,但抗菌效果并不理想。经超声波检查,我们在患者的子宫内发现了一个感染灶。随后,我们对患者进行了子宫刮宫术,用甲硝唑冲洗宫腔,并肌肉注射庆大霉素和地塞米松。治疗后,患者的生理指标逐渐恢复正常,入院 30 天后出院。金丝桃副杆菌菌血症极为罕见,临床上,这种细菌感染后的毒性似乎很大。在本报告中,我们回顾了金黄色葡萄球菌的研究历史和相关感染病例,旨在提高临床医师,尤其是妇产科医师对金黄色葡萄球菌血流感染的认识,促进早期诊断和及时治疗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Maternal puerperal infection caused by Parabacteroides goldsteinii: a case report
Parabacteroides goldsteinii, a member of the Parabacteroides genus, was initially discovered in the feces and abdominal tissue of patients with appendicitis, peritonitis, and abdominal abscesses. In recent years, P. goldsteinii has been widely regarded as a gut probiotic, and human infections have been extremely rare. In 2010, P. goldsteinii was first isolated from the blood culture of a patient with abdominal infection, confirming its ability to cause bacteremia. In this study, we report a rare case of puerperal infection with septic shock caused by P. goldsteinii infection in a pregnant woman.A 31-year-old female experienced perineal lacerations, cervical lacerations, and postpartum hemorrhage during childbirth. Nine days postpartum, the patient developed septic shock, and P. goldsteinii infection was identified through blood culture and mass spectrometry. We administered broad-spectrum antibiotics, including meropenem/nalidixic acid and piperacillin tazobactam, intravenously, but the antimicrobial effect was not satisfactory. Upon ultrasound examination, we identified a focus of infection in the patient’s uterus. Subsequently, uterine curettage was performed, followed by uterine cavity irrigation with metronidazole and intramuscular injection of gentamicin and dexamethasone. Following treatment, the patient’s physiological parameters gradually returned to normal, and she was discharged 30 days after admission.Parabacteroides goldsteinii bacteraemia is extremely rare, and clinically, the postinfection toxicity of this bacterium appears to be significant. In this report, we review the research history of P. goldsteinii and relevant infection cases, aiming to enhance awareness among clinical practitioners, particularly obstetricians and gynecologists, regarding P. goldsteinii bloodstream infections, facilitating early diagnosis and timely treatment.
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