Brucella vertebral osteomyelitis misidentified as an Ochrobactrum anthropi infection
Brucella vertebral osteomyelitis misidentified as an Ochrobactrum anthropi infection
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DOI：
10.1016/j.idcr.2018.01.010
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发表时间：
2018-01-01
期刊：
影响因子：
1.5
通讯作者：
Saraiva da Cunha, Jose Gabriel
中科院分区：
文献类型：
--
作者：
Trepa, Joao;Mendes, Patricia;Saraiva da Cunha, Jose Gabriel
人类赭杆菌是一种广泛分布于自然界的革兰氏阴性杆菌。它是一种低毒力和低致病性的微生物，人类感染这种病原体被认为是罕见的。这种微生物可引起菌血症，在某些情况下可导致骨髓炎和心内膜炎。该细菌属于布鲁氏菌科，在表型和遗传上与布鲁氏菌属密切相关，可能被快速鉴定系统错误识别。作者描述了一位被传染病科收治的椎骨骨髓炎患者，最初被鉴定为人类赭杆菌。尽管适当的抗菌药物治疗，血培养仍然呈阳性，没有临床改善的迹象。这引起了人们对可能是误认的怀疑。决定开始抗微生物治疗，包括布鲁氏菌属，缓慢但渐进的临床改善。样本被送往国家卫生部门Ricardo Jorge （INSA）进行基因分型，证实了最初的误鉴定怀疑，并确定梅利氏布鲁氏菌为致病因子。及时诊断布鲁氏菌病对于正确管理和预防其对患者造成的后果以及安全处理实验室样本和预防实验室获得性感染至关重要
Ochrobactrum anthropi is a Gram-negative bacillus widely distributed in nature. It is a low virulence and low pathogenic microorganism and human infection by this agent is considered rare. This microorganism can cause bacteremia and in some cases can lead to osteomyelitis and endocarditis. Included in Brucellaceae family, this bacterium is phenotypically and genetically closely related to the Brucella genus and may be misidentified by rapid identification systems. The authors describe a patient admitted to the Infectious Diseases Department with vertebral osteomyelitis initially identified as Ochrobactrum anthropi. Despite appropriate antimicrobial therapy, the blood cultures remained positive and there were no signs of clinical improvement. This raised suspicion of a possible misidentification. It was decided to initiate antimicrobial therapy to include the Brucella genus, with slow but progressive clinical improvement. Samples were sent to Instituto Nacional de Saude Doutor Ricardo Jorge (INSA) for genotyping, confirming the initial suspicion of misidentification and identifying Brucella melitensis as the causal agent. Timely diagnosis of brucellosis is essential for the correct management and prevention of its consequences for the patient and for safe handling of the laboratory samples, preventing laboratory-acquired infection