Erysipelothrix Rhusiopathiae Bacteremia without Endocarditis: Rapid Identification from Positive Blood Culture by MALDI-TOF Mass Spectrometry. A Case Report and Literature Review.
Erysipelothrix Rhusiopathiae Bacteremia without Endocarditis: Rapid Identification from Positive Blood Culture by MALDI-TOF Mass Spectrometry. A Case Report and Literature Review.
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DOI：
10.4081/idr.2016.6368
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发表时间：
2016-03-21
影响因子：
3.2
通讯作者：
Luzzaro F
中科院分区：
文献类型：
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作者：
Principe L;Bracco S;Mauri C;Tonolo S;Pini B;Luzzaro F
红斑丹毒丝菌是一种革兰氏阳性杆菌，很少引起人类感染。有三种类型：一种是局部皮肤型（类丹毒），由E. rhusiopathiae，全身皮肤形式和败血症形式。后一种类型的疾病以前与心内膜炎的高发病率有关。在这里我们报告一例E. 1例74岁男性的红斑病菌血症，可能始于类丹毒形式，未发生心内膜炎。本病例有以下特点：i）与动物来源无关; ii）菌血症与丹毒样病变相关; iii）无心内膜炎。MALDI-TOF质谱法可快速鉴定（培养瓶阳性后4小时内）E。红斑病与直接的抗菌药物敏感性测试一起，这种方法可以提高由于这种挑剔的病原体引起的血流感染的适当治疗率。
Erysipelothrix rhusiopathiae is a Gram-positive bacillus that is infrequently responsible for infections in humans. Three forms have been classified: a localized cutaneous form (erysipeloid) caused by traumatic penetration of E. rhusiopathiae, a generalized cutaneous form and a septicemic form. The latter type of disease has been previously associated with a high incidence of endocarditis. Here we report a case of E. rhusiopathiae bacteremia in a 74-year-old man, probably started from an erysipeloid form, in which endocarditis did not develop. This case presents some particular and uncommon features: i) no correlation with animal source; ii) correlation between bacteremia and erysipeloid lesion; iii) absence of endocarditis. MALDI-TOF mass spectrometry allowed to obtain a rapid identification (within 4 hours from bottle positivity) of E. rhusiopathiae. Together with direct antimicrobial susceptibility testing, this approach could improve the rate of appropriate therapy for bloodstream infections due to this fastidious pathogen.