<br>酒精性肝硬化患者海拉肠球菌菌血症并发急性肾盂肾炎一例报告及文献复习,BMC Infectious Diseases

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酒精性肝硬化患者海拉肠球菌菌血症并发急性肾盂肾炎一例报告及文献复习
BMC Infectious Diseases ( IF 3.4 ) Pub Date : 2021-09-23 , DOI: 10.1186/s12879-021-06707-2
Tomoaki Nakamura ₁ , Kazuhiro Ishikawa ₁ , Takahiro Matsuo ₁ , Fujimi Kawai ₂ , Yuki Uehara _{1,

3,

4,

5} , Nobuyoshi Mori ₁

Affiliation

海拉肠球菌引起的感染在动物中很常见，但传播给人类的情况很少见。此外，由于难以识别细菌，因此人类病例报告很少。本文报道一例由希拉美球菌菌血症引起的肾盂肾炎一例，并对希拉希球菌菌血症进行文献综述。一名57岁男性酒精性肝硬化神经源性膀胱患者就诊，发热、寒战持续3天。体格检查发现右侧肋椎角有压痛。对患者的血液和尿液样本进行基质辅助激光解吸电离飞行时间质谱（MALDI-TOF MS）检测，结果显示存在希拉希氏菌，诊断为肾盂肾炎。该患者接受了静脉注射氨苄西林和口服利奈唑胺总共三周的成功治疗。我们进行的文献综述显示，希拉希氏菌菌血症常见于尿路感染、胆道感染和感染性心内膜炎，并且更容易发生在糖尿病、肝硬化和慢性肾脏病患者中。然而，由于希拉伊球菌具有很高的抗菌敏感性，因此死亡率并不常见。随着MALDI-TOF MS的进步，希拉希氏菌感染的报告数量也有所增加，临床医生需要将希拉希氏菌作为具有已知危险因素的患者尿路感染的可能致病病原体。

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Enterococcus hirae bacteremia associated with acute pyelonephritis in a patient with alcoholic cirrhosis: a case report and literature review

Infections caused by Enterococcus hirae are common in animals, with instances of transmission to humans being rare. Further, few cases have been reported in humans because of the difficulty in identifying the bacteria. Herein, we report a case of pyelonephritis caused by E. hirae bacteremia and conduct a literature review on E. hirae bacteremia. A 57-year-old male patient with alcoholic cirrhosis and neurogenic bladder presented with fever and chills that had persisted for 3 days. Physical examination revealed tenderness of the right costovertebral angle. Matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) of the patient’s blood and urine samples revealed the presence of E. hirae, and pyelonephritis was diagnosed. The patient was treated successfully with intravenous ampicillin followed by oral linezolid for a total of three weeks. The literature review we conducted revealed that E. hirae bacteremia is frequently reported in urinary tract infections, biliary tract infections, and infective endocarditis and is more likely to occur in patients with diabetes, liver cirrhosis, and chronic kidney disease. However, mortality is not common because of the high antimicrobial susceptibility of E. hirae. With the advancements in MALDI-TOF MS, the number of reports of E. hirae infections has also increased, and clinicians need to consider E. hirae as a possible causative pathogen of urinary tract infections in patients with known risk factors.

更新日期：2021-09-24

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