국내 일개 병원에서의 Elizabethkingia meningoseptica 성인 감염 3예
Three Adult Cases of Elizabethkingia meningoseptica Infection in a Korean Hospital
0
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Elizabethkingia meningoseptica (Chryseobacterium meningoseptica)은 비발효성 그람음성 간균으로 자연환경이나 병원환경에서 흔히 분리된다. 이 균종은 주로 신생아 수막염을 잘 일으키는 것으로 알려져 있으나 성인에서는 기저질환이 있어 면역이 저하된 경우에만 매우 드물게 감염을 일으킬 수 있다. E. meningoseptica은 그람음성간균에 통상적으로 사용되는 aminoglycoside계, β-lactam계 항생제, tetracyclines, chloramphenicol 등에 자연내성이고 CLSI 지침에서도 항균제 치료 지침이 되는 최소억제농도가 아직 제시되지 않아 효과적인 항균제를 선택하기 어렵다. 저자들은 최근 3년 동안 본원에 입원하였던 성인 환자에서 분리된 E. meningoseptica 3예(혈액 2예 및 뇌척수액 1예)를 문헌고찰과 함께 보고하는 바이다. E. meningoseptica에 의한 성인 수막염은 국내에서는 본 증례가 첫 보고이다.
Abstract
Elizabethkingia meningoseptica (Chryseobacterium meningoseptica) is a ubiquitous Gram-negative bacillus in the natural and hospital environments. This microorganism causes neonatal meningitis but rarely causes infections in adults, with most adult cases occurring in severely immunocompromised patients. Since E. meningoseptica is inherently resistant to the usual empiric therapy aimed at Gram-negative bacilli and MIC breakpoints for resistance and susceptibility of E. meningoseptica have not been established by the Clinical and Laboratory Standards Institute, it is very difficult to select effective antibiotics for the treatment of E. meningoseptica infection. We report here three cases of E. meningoseptica isolates (two from blood and one from CSF) from adult patients admitted to Seoul St. Mary’s hospital over a 3-year period. To the best of our knowledge, this is the first report of adult meningitis due to E. meningoseptica in Korea
참고문헌 (8)
- Bloch KC, "Chryseobacterium meningosepticum: an emerging pathogen among immunocompromised adults. Report of 6 cases and literature review", Medicine (Baltimore), 76, pp.30~41 (1997)
- Kim KK, "Transfer of Chryseobacterium meningosepticum and Chryseobacterium miricola to Elizabethkingia gen. nov. as Elizabethkingia meningoseptica comb. nov. and Elizabethkingia miricola comb. nov", Int J Syst Evol Microbiol, 55, pp.1287~1293 (2005)
- Lin YT, "Clinical and microbiological analysis of Elizabethkingia meningoseptica bacteremia in adult patients in Taiwan", Scand J Infect Dis, 41, pp.628~634 (2009)
- Murray PB, "Manual of Clinical Microbiology", pp.791~793 (2007), American Society for Microbiology
- Clinical and Laboratory Standards Institute (CLSI), "Performance standards for antimicrobial susceptibility testing 19th informational supplement. CLSI document M100, S17", Standards Institute, ~ (2009)
- Jong Hwa Yum, "Genetic Diversity of Chromosomal Metallo-β-Lactamase Genes in Clinical Isolates of Elizabethkingia meningoseptica from Korea", The Journal of Microbiology, 48(3), pp.358~364 (2010), 한국미생물학회
- Lee NY, "Annual report on external quality assessment in clinical microbiology laboratory in Korea (2008)", J Lab Med Qual Assur, 31, pp.13~27 (2009)
- Kirby JT, "Antimicrobial susceptibility and epidemiology of a worldwide collection of Chryseobacterium spp: report from the SENTRY Antimicrobial Surveillance Program (1997-2001)", J Clin Microbiol, 42, pp.445~448 (2004)