Elizabethkingia anophelis bacteremia is associated with clinically significant infections and high mortality.
Elizabethkingia anophelis bacteremia is associated with clinically significant infections and high mortality.
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DOI：
10.1038/srep26045
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发表时间：
2016-05-17
影响因子：
4.6
通讯作者：
Woo PC
中科院分区：
文献类型：
--
作者：
Lau SK;Chow WN;Foo CH;Curreem SO;Lo GC;Teng JL;Chen JH;Ng RH;Wu AK;Cheung IY;Chau SK;Lung DC;Lee RA;Tse CW;Fung KS;Que TL;Woo PC
与脑膜炎败血症嗜沙金杆菌不同，E.对按蚊知之甚少。我们确定了临床和分子流行病学菌血症所引起的类嗜热金杆菌种在香港的五个区域医院。在45例嗜酸金杆菌样菌血症中，21例由嗜酸金杆菌引起，其中17例为E. anophelis，3株E. meningoseptica和1株E.而24个由其他不同的属/种引起，如通过16 S rRNA基因测序所确定的。17例E. 15例（88%）有临床意义。最常见的诊断是肺炎（n = 5），其次是导管相关菌血症（n = 4），新生儿脑膜炎（n = 3），医院内菌血症（n = 2）和血小板减少性发热（n = 1）。E.按蚊菌血症常伴有并发症，死亡率为23.5%。相比之下，在24例由非嗜酸菌属引起的菌血症中，16例（67%）在临床上不显著。与非嗜酸菌菌血症相比，嗜酸菌菌血症与临床显著感染（P < 0.01）和其他部位培养阳性（P < 0.01）有关，多菌血症较少（P <0.01），并发症（P < 0.05）和死亡率（P < 0.05）较高。嗜热金杆菌菌血症主要由E. anophelis而不是E.脑膜炎嗜酸杆菌菌血症，特别是由于E.按蚊携带显著的发病率和死亡率，除非另有证明，否则应被认为具有临床意义。
Unlike Elizabethkingia meningoseptica, the clinical importance of E. anophelis is poorly understood. We determined the clinical and molecular epidemiology of bacteremia caused by Elizabethkingia-like species from five regional hospitals in Hong Kong. Among 45 episodes of Elizabethkingia-like bacteremia, 21 were caused by Elizabethkingia, including 17 E. anophelis, three E. meningoseptica and one E. miricola; while 24 were caused by other diverse genera/species, as determined by 16S rRNA gene sequencing. Of the 17 cases of E. anophelis bacteremia, 15 (88%) were clinically significant. The most common diagnosis was pneumonia (n = 5), followed by catheter-related bacteremia (n = 4), neonatal meningitis (n = 3), nosocomial bacteremia (n = 2) and neutropenic fever (n = 1). E. anophelis bacteremia was commonly associated with complications and carried 23.5% mortality. In contrast, of the 24 episodes of bacteremia due to non-Elizabethkingia species, 16 (67%) were clinically insignificant. Compared to non-Elizabethkingia bacteremia, Elizabethkingia bacteremia was associated with more clinically significant infections (P < 0.01) and positive cultures from other sites (P < 0.01), less polymicrobial bacteremia (P < 0.01), and higher complication (P < 0.05) and mortality (P < 0.05) rates. Elizabethkingia bacteremia is predominantly caused by E. anophelis instead of E. meningoseptica. Elizabethkingia bacteremia, especially due to E. anophelis, carries significant morbidity and mortality, and should be considered clinically significant unless proven otherwise.