与副卡林杆菌感染相关的肉芽肿性小叶乳腺炎患者的临床特征和分离菌株的药物敏感性分析。

IF 4.6 2区 医学 Q1 MICROBIOLOGY
Yifei Zeng, Mengjie Wang, Xiang Gao, Dongxiao Zhang, Na Fu, Wenjie Zhao, Qiao Huang
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引用次数: 0

摘要

背景:目前认为,棒状杆菌,尤其是克罗彭氏棒状杆菌(CK)感染,是肉芽肿性小叶性乳腺炎(GLM)的重要病因之一。然而,近两年乳腺炎的病原体已被确定为一种新发现的科里纳杆菌。但还不清楚与 GLM 发生相关的病原体是否也是这种细菌:方法:选取2023年2月至2024年2月脓液标本细菌培养阳性、经质谱仪鉴定为CK感染的GLM女性患者作为研究对象,通过16S rDNA测序技术对临床分离株进行鉴定,确定GLM相关细菌感染的特异性病原体。随后,将患者的临床特征与同期无细菌感染的 GLM 患者的临床特征进行比较,探讨这种特殊类型的棒状杆菌感染对 GLM 患者疾病发展的影响。最后,我们通过 E-Test 实验测试了抗生素在体外抑制这些分离菌株时的最小抑菌浓度 (MIC),以评估其药物敏感性:研究共纳入了 31 名通过 MALDI-TOF MS 初步诊断为克罗彭氏棒状杆菌(CK)感染的 GLM 患者。然而,随后的 16S rDNA 测序显示,28 个分离株(90.32%)实际上被鉴定为新发现的副克罗彭氏棒状杆菌(CPK)。这一发现挑战了 CK 是 GLM 主要病原体的传统观点,表明 CPK 才是与 GLM 细菌感染相关的主要病原体。对两组患者临床特征的比较分析表明,与未感染 CPK 的患者相比,感染 CPK 的 GLM 患者的复发率明显更高,同时催乳素水平也有所升高(P,结论:CPK 感染的 GLM 患者复发率明显高于未感染 CPK 的 GLM 患者):总之,本研究强调,从 GLM 标本中分离出的克罗彭氏棒状杆菌菌株是副克罗彭氏棒状杆菌,是与 GLM 发生密切相关的主要病原体。CPK 感染会大大增加 GLM 患者的复发风险,而催乳素水平的升高可能在这一过程中起到关键作用。在临床抗菌治疗中,当药敏试验结果不确定时,可根据经验使用青霉素和环丙沙星以外的抗菌药物。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Clinical characteristics of patients with granulomatous lobular mastitis associated with Corynebacterium parakroppenstedtii infection and drug sensitivity analysis of the isolated strains.

Background: It is presently considered that Corynebacterium especially Corynebacterium kroppenstedtii (CK) infection, is one of the important causes of granulomatous lobular mastitis (GLM). However, the pathogen of mastitis in the past two years has been identified as a newly discovered Corynebacterium. But it is unclear whether the pathogen associated with the occurrence of GLM is also this bacterium.

Methods: GLM female patients with positive bacterial culture in pus specimens from February 2023 to February 2024 who were identified as CK infection by mass spectrometer were selected as the research objects in this study, and the clinical isolates were identified by 16S rDNA sequencing technology to identify the specific pathogen of GLM-related bacterial infection. Subsequently, the clinical characteristics of the patients were compared with those of GLM patients without bacterial infection during the same period, to explore the effect of this particular type of Corynebacterium infection on disease development in GLM patients. Finally, we tested the minimum inhibitory concentration (MIC) values of antibiotics when inhibiting these separation strains in vitro through the E-Test experiment, to evaluate their medicine sensitivity.

Results: A total of 31 GLM patients initially diagnosed with Corynebacterium kroppenstedtii (CK) infection via MALDI-TOF MS were enrolled in the study. However, subsequent 16S rDNA sequencing revealed that 28 isolates (90.32%) were actually identified as the newly recognized Corynebacterium parakroppenstedtii (CPK). This discovery challenges the conventional belief that CK is the primary pathogen of GLM, suggesting instead that CPK is the predominant pathogen associated with GLM bacterial infections. Comparative analysis of the clinical characteristics between the two groups revealed a significantly higher recurrence rate among CPK-infected GLM patients compared to those without CPK infection, along with elevated prolactin levels (P < 0.05). The sensitivity test results indicated high sensitivity of the isolates to vancomycin, linezolid, and rifampicin.

Conclusion: In conclusion, this study highlights that Corynebacterium kroppenstedtii strains isolated from GLM specimens were Corynebacterium parakroppenstedtii, serving as the primary pathogen closely linked to GLM's occurrence. CPK infection significantly increases the risk of recurrence in GLM patients, with elevated prolactin levels potentially playing a pivotal role in this process. In clinical antimicrobial treatment, antimicrobials other than penicillin and ciprofloxacin may be empirically administered when sensitivity test results are inconclusive.

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来源期刊
CiteScore
8.60
自引率
0.00%
发文量
49
审稿时长
>12 weeks
期刊介绍: Annals of Clinical Microbiology and Antimicrobials considers good quality, novel and international research of more than regional relevance. Research must include epidemiological and/or clinical information about isolates, and the journal covers the clinical microbiology of bacteria, viruses and fungi, as well as antimicrobial treatment of infectious diseases. Annals of Clinical Microbiology and Antimicrobials is an open access, peer-reviewed journal focusing on information concerning clinical microbiology, infectious diseases and antimicrobials. The management of infectious disease is dependent on correct diagnosis and appropriate antimicrobial treatment, and with this in mind, the journal aims to improve the communication between laboratory and clinical science in the field of clinical microbiology and antimicrobial treatment. Furthermore, the journal has no restrictions on space or access; this ensures that the journal can reach the widest possible audience.
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