達卡氣單胞菌致膿毒性休克一例并文獻復習_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

裴文婧 , 劉輝 , 高磊 , 胡昆 ,  鄭凌 ,  葉靜

安徽醫科大學第二附屬醫院呼吸與危重癥醫學科（安徽合肥 230601）;

Corresponding?author：

鄭凌, Email: limpidkid_zheng@sina.com; 葉靜, Email: plowchan@126.com

Keywords：

達卡氣單胞菌; 氣單胞菌; 膿毒性休克; 血流感染; 病案報告

DOI：

10.7507/1671-6205.202110038

Video：

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目的了解達卡氣單胞菌的特點、致病性及該菌感染的臨床特點、治療、轉歸及耐藥性。方法報告1例呼吸重癥監護室收治的達卡氣單胞菌感染的膿毒性休克致死病例，整理患者臨床資料并回顧文獻。結果患者男，69歲，既往胃惡性腫瘤及腎腫瘤手術史，此次系“乏力3 d，發熱咳嗽2 d，加重伴悶喘半天”入院，入院時存在呼吸衰竭及酸中毒，胸部CT斑片狀高密度影，考慮為膿毒癥，治療上經驗性使用廣譜抗生素抗感染，輔以呼吸循環支持治療，肺泡灌洗液送檢相關病原學檢查，但本例患者病情進展迅速，細菌培養結果未出即臨床死亡，后基因測序結果提示達卡氣單胞菌。文獻回顧納入3例患者，均短時間內死亡，且均通過基因測序檢出該菌。達卡氣單胞菌是一種條件致病菌，廣泛分布于水生環境中，侵襲性強，致死率高。結論達卡氣單胞菌感染病情兇險，臨床表現無顯著特異性，基因測序能有效鑒別該菌，治療上需謹慎選擇抗生素，該菌感染預后差，目前該菌已出現多種耐藥菌株。

Citation： 裴文婧, 劉輝, 高磊, 胡昆, 鄭凌, 葉靜. 達卡氣單胞菌致膿毒性休克一例并文獻復習. Chinese Journal of Respiratory and Critical Care Medicine, 2022, 21(11): 815-819. doi: 10.7507/1671-6205.202110038 Copy

1.	Ottaviani D, Parlani C, Citterio B, et al. Putative virulence properties of Aeromonas strains isolated from food, environmental and clinical sources in Italy: a comparative study. Int J Food Microbiol, 2011, 144(3): 538-545.
2.	Kitagawa H, Ohge H, Yu LS, et al. Aeromonas dhakensis is not a rare cause of Aeromonas bacteremia in Hiroshima, Japan. J Infect Chemother, 2020, 26(2): 316-320.
3.	Huang MX, Chen HT, Li CN, et al. Rapid fulminant progression and mortality secondary to Aeromonas dhakensis septicemia with hepatitis B virus infection following the ingestion of snakehead fish in Mainland China: a case report. Foodborne Pathog Dis, 2020, 17(12): 743-749.
4.	Chang HL, Chen PL, Lin SY, et al. Two fatal cases of Aeromonas dhakensis bacteremia and necrotizing fasciitis in severe dengue patients. J Microbiol Immunol Infect, 2018, 51(5): 692-694.
5.	朱衛華, 覃煜, 王成中. 血清膽紅素水平對膿毒血癥患者預后的臨床意義. 內科急危重癥雜志, 2019, 25(3): 234-236.
6.	Patel JJ, Taneja A, Niccum D, et al. The association of serum bilirubin levels on the outcomes of severe sepsis. J Intensive Care Med, 2015, 30(1): 23-29.
7.	Beaz-Hidalgo R, Martínez-Murcia A, Figueras MJ. Reclassification of Aeromonas hydrophila subsp. dhakensis Huys et al. 2002 and Aeromonas aquariorum Martínez-Murcia et al. 2008 as Aeromonas dhakensis sp. nov. comb nov. and emendation of the species Aeromonas hydrophila. Syst Appl Microbiol, 2013, 36(3): 171-176.
8.	周妍妍, 南征, 閆東輝, 等. 3種方法鑒定氣單胞菌臨床分離株效果分析. 疾病監測, 2019, 34(1): 70-75.
9.	Morinaga Y, Yanagihara K, Eugenin FL, et al. Identification error of Aeromonas aquariorum: a causative agent of septicemia. Diagn Microbiol Infect Dis, 2013, 76(1): 106-109.
10.	Chen PL, Wu CJ, Chen CS, et al. A comparative study of clinical Aeromonas dhakensis and Aeromonas hydrophila isolates in southern Taiwan: A. dhakensis is more predominant and virulent. Clin Microbiol Infect, 2014, 20(7): O428-O434.
11.	方海英, 李醫, 陳曉, 等. 腸道外感染氣單胞菌屬的臨床分布與耐藥性分析. 中華醫院感染學雜志, 2015, 25(7): 1454-1456.
12.	Murata M, Morinaga Y, Akamatsu N, et al. The rapid induction of Carbapenem-resistance in an Aeromonas dhakensis blood isolate. Jpn J Infect Dis, 2016, 69(5): 439-441.
13.	Wu CJ, Wang HC, Chen PL, et al. AQU-1, a chromosomal class C β-lactamase, among clinical Aeromonas dhakensis isolates: distribution and clinical significance. Int J Antimicrob Agents, 2013, 42(5): 456-461.

1. Ottaviani D, Parlani C, Citterio B, et al. Putative virulence properties of Aeromonas strains isolated from food, environmental and clinical sources in Italy: a comparative study. Int J Food Microbiol, 2011, 144(3): 538-545.
2. Kitagawa H, Ohge H, Yu LS, et al. Aeromonas dhakensis is not a rare cause of Aeromonas bacteremia in Hiroshima, Japan. J Infect Chemother, 2020, 26(2): 316-320.
3. Huang MX, Chen HT, Li CN, et al. Rapid fulminant progression and mortality secondary to Aeromonas dhakensis septicemia with hepatitis B virus infection following the ingestion of snakehead fish in Mainland China: a case report. Foodborne Pathog Dis, 2020, 17(12): 743-749.
4. Chang HL, Chen PL, Lin SY, et al. Two fatal cases of Aeromonas dhakensis bacteremia and necrotizing fasciitis in severe dengue patients. J Microbiol Immunol Infect, 2018, 51(5): 692-694.
5. 朱衛華, 覃煜, 王成中. 血清膽紅素水平對膿毒血癥患者預后的臨床意義. 內科急危重癥雜志, 2019, 25(3): 234-236.
6. Patel JJ, Taneja A, Niccum D, et al. The association of serum bilirubin levels on the outcomes of severe sepsis. J Intensive Care Med, 2015, 30(1): 23-29.
7. Beaz-Hidalgo R, Martínez-Murcia A, Figueras MJ. Reclassification of Aeromonas hydrophila subsp. dhakensis Huys et al. 2002 and Aeromonas aquariorum Martínez-Murcia et al. 2008 as Aeromonas dhakensis sp. nov. comb nov. and emendation of the species Aeromonas hydrophila. Syst Appl Microbiol, 2013, 36(3): 171-176.
8. 周妍妍, 南征, 閆東輝, 等. 3種方法鑒定氣單胞菌臨床分離株效果分析. 疾病監測, 2019, 34(1): 70-75.
9. Morinaga Y, Yanagihara K, Eugenin FL, et al. Identification error of Aeromonas aquariorum: a causative agent of septicemia. Diagn Microbiol Infect Dis, 2013, 76(1): 106-109.
10. Chen PL, Wu CJ, Chen CS, et al. A comparative study of clinical Aeromonas dhakensis and Aeromonas hydrophila isolates in southern Taiwan: A. dhakensis is more predominant and virulent. Clin Microbiol Infect, 2014, 20(7): O428-O434.
11. 方海英, 李醫, 陳曉, 等. 腸道外感染氣單胞菌屬的臨床分布與耐藥性分析. 中華醫院感染學雜志, 2015, 25(7): 1454-1456.
12. Murata M, Morinaga Y, Akamatsu N, et al. The rapid induction of Carbapenem-resistance in an Aeromonas dhakensis blood isolate. Jpn J Infect Dis, 2016, 69(5): 439-441.
13. Wu CJ, Wang HC, Chen PL, et al. AQU-1, a chromosomal class C β-lactamase, among clinical Aeromonas dhakensis isolates: distribution and clinical significance. Int J Antimicrob Agents, 2013, 42(5): 456-461.

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達卡氣單胞菌致膿毒性休克一例并文獻復習

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