Rothia Bacteremia: a 10-Year Experience at Mayo Clinic, Rochester, Minnesota
Rothia Bacteremia: a 10-Year Experience at Mayo Clinic, Rochester, Minnesota
复制标题
DOI：
10.1128/jcm.01270-14
复制
发表时间：
2014-09-01
影响因子：
9.4
通讯作者：
Tosh, Pritish K.
中科院分区：
文献类型：
--
作者：
Ramanan, Poornima;Barreto, Jason N.;Tosh, Pritish K.
罗氏杆菌属是革兰氏阳性球菌，可引起广泛的严重感染，特别是在免疫功能低下的宿主中。粘胶罗氏菌（以前称为粘胶口球菌）菌血症的危险因素包括长期和深度中性粒细胞减少、恶性肿瘤和血管内留置异物。在这里，我们描述了从2002年到2012年在明尼苏达州罗切斯特市梅奥诊所的67名成年人，他们的血培养呈罗氏菌阳性。其中25例患者多次血培养阳性，表明真正的临床感染。其中88%（22/25）为中性粒细胞减少症，76%（19/25）为白血病。常见的菌血症来源被认为是肠道易位、粘膜炎和导管相关感染。一名患者死于罗氏菌感染。与非中性粒细胞减少患者相比，中性粒细胞减少患者单纯血培养阳性的可能性更小。21%的分离株进行了药敏试验。所有分离株均对万古霉素和大部分β -内酰胺敏感；然而，6个测试的分离株中有4个对oxacillin耐药。中性粒细胞减少症和非中性粒细胞减少症患者在重症监护病房护理、死亡率或归因死亡率方面没有差异。
Rothia spp. are Gram-positive cocco-bacilli that cause a wide range of serious infections, especially in immunocompromised hosts. Risk factors for Rothia mucilaginosa (previously known as Stomatococcus mucilaginosus) bacteremia include prolonged and profound neutropenia, malignancy, and an indwelling vascular foreign body. Here, we describe 67 adults at the Mayo Clinic in Rochester, MN, from 2002 to 2012 with blood cultures positive for Rothia. Twenty-five of these patients had multiple positive blood cultures, indicating true clinical infection. Among these, 88% (22/25) were neutropenic, and 76% (19/25) had leukemia. Common sources of bacteremia were presumed gut translocation, mucositis, and catheter-related infection. One patient died with Rothia infection. Neutropenic patients were less likely to have a single positive blood culture than were nonneutropenic patients. Antimicrobial susceptibility testing was performed on 21% of the isolates. All of the tested isolates were susceptible to vancomycin and most beta-lactams; however, four of six tested isolates were resistant to oxacillin. There was no difference between the neutropenic and nonneutropenic patients in need of intensive care unit care, mortality, or attributable mortality.