摘要
目的了解马红球菌(R.equi)的特点及其所引起疾病的临床特征,提高对马红球菌感染的认识。方法回顾性分析1例肾移植术后马红球菌肺脓肿患者的临床资料,结合文献复习探讨马红球菌及其所致马红球菌感染的特征。结果该例患者临床表现和实验室检查符合马红球菌感染特征,痰液及血培养均查见马红球菌生长,经治疗后取得了较好的疗效。复习文献,包括本例在内共报道24例患者,其中男17例,女7例。肾移植术后感染时间范围4个月至11年。感染累及肺部的病例21例,在10例报道中存在明确的流行病学史。18例患者在接受规律抗菌治疗或手术治疗后好转。结论马红球菌引起的机会性感染主要影响移植受体以及其他免疫功能低下的患者群体。感染可累及全身各个系统,以肺部感染最为多见,临床症状无特异性。由于该类疾病罕见,治疗方案暂无统一标准,需结合药敏结果及患者治疗反应而定。
Objective To examine the characteristics of Rhodococcus equi(R.equi)infection for better awareness of this disease.Methods The clinical data of a patient with pulmonary abscess caused by R.equi after renal transplantation were reported.We also reviewed the reports of infections caused by R.equi.Results The clinical manifestations and laboratory examination of the patient were consistent with the characteristics of R.equi infection.The growth of R.equi was found in sputum and blood culture.The follow-up data showed that the treatment was effective.Literature search identified 23 similar patients.In all the 24 patients(containing this one),the time of infection after renal transplantation ranged from 4 months to 11 years.There were 21 patients with cumulative pulmonary infection,and 10 patients had a clear epidemiological history of direct or indirect contact with horses.Eighteen patients improved after regular antibacterial treatment or surgical treatment.Conclusions Opportunistic infections caused by R.equi mainly affect transplant recipients and other patients with lower immunity.Infections caused by R.equi may affect many organ systems with various manifestations.The optimal therapy is not established due to the rarity of this infection.Clinicians should select antibiotic agents rationally based on antimicrobial susceptibility testing and treatment response of patients.
作者
王能
唐骢宸
王丽春
WANG Neng;TANG Congchen;WANG Lichun(Center of Infectious Disease,West China Hospital,Sichuan University,Chengdu,Sichuan 610041,P.R.China)
出处
《中国呼吸与危重监护杂志》
CAS
CSCD
北大核心
2021年第8期558-563,共6页
Chinese Journal of Respiratory and Critical Care Medicine
关键词
马红球菌
肾移植
肺部脓肿
抗菌药物
治疗方案
Rhodococcus equi
Kidney transplantation
Lung abscess
Antimicrobial agents
Treatment
