Granulicatella adiacens Bacteremia in Chronic Granulomatous Disease.
Granulicatella adiacens Bacteremia in Chronic Granulomatous Disease.
复制标题
慢性肉芽肿病中的颗粒菌菌血症。
DOI：
10.1007/s10875-022-01371-w
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发表时间：
2023
期刊：
影响因子：
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通讯作者：
Kawai T.
中科院分区：
文献类型：
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作者：
Okai M;Ishikawa T;Tamura E;Matsui T;Kawai T.
颗粒菌是一种与其他微生物共生的细菌，包括葡萄球菌，它们定植在人类口腔、肠道和泌尿器官的正常细菌群中。与引起CGD复发性感染的葡萄球菌不同，Granulicatella属过氧化氢酶阴性菌；因此，CGD患者对颗粒菌感染的易感性并未增加。相比之下，粒细胞减少症患者出现颗粒菌感染，分类为吞噬细胞紊乱。其他研究报道，由颗粒菌引起的8例菌血症中有7例发生在中性粒细胞减少症患者中。虽然CGD患者表现出中性粒细胞产生ROS功能障碍，但外周血中性粒细胞计数通常维持在正常范围内。众所周知，包括美罗培南、万古霉素和头孢吡肟在内的抗生素可引起中性粒细胞减少症。在本报告中，患者在使用头孢吡肟治疗期间出现中性粒细胞减少，停用头孢吡肟后消失。一般来说，中性粒细胞减少患者发生的肉芽孢杆菌感染与化疗、血液恶性肿瘤和抗生素使用有关。在我们的病例中，在药物相关性中性粒细胞减少症期间发生了棘芽胞杆菌菌血症。
DiscussionGranulicatella species is a commensal bacterium with other microorganisms, including Staphylococcus species, which colonize normal bacterial flora in the human oral cavity, intestine, and urinary organs. Unlike Staphylococcus species that cause recurrent infections in CGD, Granulicatella species is classified in catalase-negative bacterium; therefore, patients with CGD did not present increasing susceptibility to infection of Granulicatella species. In contrast, Granulicatella species infection developed in patients with neutropenia classified as phagocyte disorders. Other studies reported that seven of eight cases of bacteremia caused by Granulicatella species developed in patients with neutropenia [2]. Although patients with CGD demonstrated dysfunction of neutrophils to produce ROS, the neutrophil counts in the peripheral blood were usually maintained within the normal range. It is well known that antibiotics, including meropenem, vancomycin, and cefepime, can cause neutropenia [2]. In the present report, the neutropenia of the patient occurred during treatment with cefepime and resolved after stopping cefepime. Generally, Granulicatella infections developing in patients with neutropenia were associated with chemotherapy, hematological malignancies, and antibiotic use. In our case, Granulicatella adiacens bacteremia developed during drug-related neutropenia.