社区相关性耐甲氧西林金黄色葡萄球菌USA300克隆引起播散性感染致死1例

IF 1.3 4区 医学 Q4 INFECTIOUS DISEASES
Hiroyuki Ote, Hideyuki Ito, Taroh Akira, Motoyuki Sugai, Junzo Hisatsune, Yuki Uehara, Yuichiro Oba
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引用次数: 0

摘要

耐甲氧西林金黄色葡萄球菌(MRSA) USA300是全球具有代表性的社区相关性MRSA (CA-MRSA)克隆。在此,我们报告一例无法抢救的USA300克隆感染患者。一名25岁的男男性行为者出现持续一周的发热和臀部皮肤损伤等症状。计算机断层成像显示多发结节和实变,特别是在肺周围野,右髂静脉血栓形成,双侧大腿内侧化脓性肌炎。血液培养显示MRSA菌血症。患者病情迅速恶化,并发急性呼吸窘迫综合征和感染性心内膜炎。尽管在第6天进行了插管,但他在第9天死亡。对该患者的MRSA菌株进行多位点序列分型,序列为8型,具有mec IVa型葡萄球菌盒染色体、ptonvalentine - leukocidin基因和精氨酸分解代谢移动元件,提示存在USA300克隆。CA-MRSA皮肤病变表现为下体疖或痈的患者发生严重疾病的风险较高。患者的背景、外观和皮肤病变的位置对于严重CA-MRSA感染的早期诊断至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A Fatal Case of Disseminated Infection Caused by Community-Associated Methicillin-Resistant Staphylococcus aureus USA300 Clone.

Methicillin-resistant Staphylococcus aureus (MRSA) USA300 is a representative community-associated MRSA (CA-MRSA) clone worldwide. Herein, we report the case of a patient with USA300 clone infection who could not be salvaged. A 25-year-old man who had sex with men presented with symptoms including fever persisting for one week and skin lesions located on the buttocks. Computed tomography imaging showed multiple nodules and consolidations, especially in the peripheral lung fields, right iliac vein thrombosis, and pyogenic myositis of medial thighs bilaterally. Blood cultures revealed MRSA bacteremia. The patient's condition deteriorated rapidly, complicated by acute respiratory distress syndrome and infective endocarditis. Despite the intubation on the 6th hospital day, he died on the 9th day. Multilocus sequence typing of this patient's MRSA strain revealed sequence type 8 with a staphylococcal cassette chromosome of mec type IVa, Panton-Valentine leukocidin gene, and the arginine catabolic mobile element, indicating presence of the USA300 clone. Patients with CA-MRSA skin lesions presenting with furuncles or carbuncles on the lower body are at a higher risk of severe disease. The patient's background, appearance, and location of skin lesions are critical for the early diagnosis of severe CA-MRSA infection.

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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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