徐建国, 赖心河, 傅晓丽, 杨红梅, 余秀军, 吴纪民, 黄力保, 吴艳萍, 刘秉阳, 武仰晶. 一例罕见的多种细菌协同性坏疽的病原学研究[J]. 疾病监测, 1995, 10(10): 300-304. DOI: 10.3784/j.issn.1003-9961.1995.10.300
引用本文: 徐建国, 赖心河, 傅晓丽, 杨红梅, 余秀军, 吴纪民, 黄力保, 吴艳萍, 刘秉阳, 武仰晶. 一例罕见的多种细菌协同性坏疽的病原学研究[J]. 疾病监测, 1995, 10(10): 300-304. DOI: 10.3784/j.issn.1003-9961.1995.10.300
Xu Jianguo. et al, . Eitiological Study on a Rare Multibacterial Synergetic Gangrene[J]. Disease Surveillance, 1995, 10(10): 300-304. DOI: 10.3784/j.issn.1003-9961.1995.10.300
Citation: Xu Jianguo. et al, . Eitiological Study on a Rare Multibacterial Synergetic Gangrene[J]. Disease Surveillance, 1995, 10(10): 300-304. DOI: 10.3784/j.issn.1003-9961.1995.10.300

一例罕见的多种细菌协同性坏疽的病原学研究

Eitiological Study on a Rare Multibacterial Synergetic Gangrene

  • 摘要: 山东省一小姑娘,患不明原因上肢末梢进行性坏疽,长期多种抗生素和清创、截肢术同用也未能控制病情发展,病因不明,病情险恶,曾引起社会的关注。本文报道,从患者深部组织标本共分离出8种细菌,包括金黄色葡萄球菌、铜绿假单胞菌、溶齿放线菌、迟缓优杆菌、延展消化链球菌、低酸链球菌和两种目前还不能鉴定的细菌:YP菌株和Y6-9菌株。血清学研究发现患者血清具有针对金黄色葡萄球菌、铜绿假单胞菌、迟缓优杆菌、延展消化链球菌,低酸链球菌,Y6-9和YP菌株的特异性抗体,药敏试验发现在所有检测的59种抗生素中,铜绿假单胞菌对其中37种耐药,仅有头孢哌酮、氧哌嗪青霉素、妥布霉素和泰能对8种细菌都有效,患者对头孢哌酮、氧哌嗪青霉素临床上没有反应,在治疗过程中没有使用妥布霉素。首次使用泰能10天左右,病情便得到了控制。结果提示此病是一种由罕见细菌参与的多细菌协同性坏疽。

     

    Abstract: A thirteen years old girl from Shandong province,China,suffered from a rare deep tissue progressive gangrene of upper extremities,for which the etioloical agent was un-known.The gangrene was so severe that it could not be limited by long term antibiotics treatment couplig with incision,debridement and radical amputation.The case had been concerned by the society ans news medium.With samples taken from deep tissue of the patient,eight species of bacteria were isolated,named as Staphylococcus aureus,Streptococcus acidominimus,Actinomyces odontolyticus,Eubacterium lentum,Peptostreptococcus productus.Pseudomonas aeruginosa and two unidentifiable organisms,which did not match any species of the proven list of bacteria-called Y6-9 and YP.By using western blot method,it was proved that patient's serum contained specific antibodies against all of the isolated bacterial species mentioned except A.odontolytics.Antibiotics susceptibility data showed that Pseudomonas aeruginosa strain was resistent to 37 of the 59 antibiotics tested.Only 4 of the 59 were effectively against all of the 8 bactenal species,named as cefoperazone,piperacillin,tobramycin and tienemimipenem+cilaastain sodium.The patient didn't respond clinically to cefoperaxone and piperacillin.Tobramycin was not used for treatment.When tienem was used,the infection was controlled.Our data suggested that it was a multibacterial synergetic gangrene.

     

/

返回文章
返回