Streptococcus lutetiensis에 의한 지발형 신생아 균혈증과 수막염 1례
A Case of Late Onset Neonatal Bacteremia and Meningitis Caused by Streptococcus lutetiensis
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Streptococcus bovis에 의한 신생아 침습감염을 보고한 사례는 많지 않으며, 지금까지 보고된 증례는 대부분 Streptococcus pasteurianus가 원인이었다. 저자들은 생후 28일에 열이 나서 온 환자의 혈액과 뇌척수액에서 분리된 균주를 16S rRNA와 tuf 유전자 염기서열분석을 통해 Streptococcus lutetiensis로 동정할 수 있었다. 환자의 혈액에서 배양된 균주는 자동화 장비(VITEK 2)에서 Streptococcus infantarius로 동정되었고 뇌척수액에서 자란 균주는 동정되지 않았다. 환자는 항균제 투여 2일째부터 열이 떨어지고 전신상태가 호전되었으며, 14일간 항균제 사용 후 신경학적 합병증 없이 퇴원하였다. 저자들은 S. bovis군에 의한 침습 감염 환자에서 정확한 균주 동정을 위해 분자유전학적 검사기법이 도움이 될 수 있음을 확인하였고 본 증례의 원인 균주가 신생아 침습감염의 원인으로 알려진 사례가 없어 보고하는 바이다.
Abstract
Invasive infection of the Streptococcus bovis group in a neonate is rare. In cases reported to date, the pathogen of neonatal S. bovis infections is usually Streptococcus gallolyticus subsp. pasteurianus (S. bovis biotype II/2). Streptococcus lutetiensis (S. bovis biotype II/1) was identified using 16S rRNA and tuf gene sequence analysis of the isolates from blood and cerebrospinal fluid (CSF) of a fever-presenting 28-day-old male. Blood culture analysis was performed using automatic equipment (VITEK 2) and identified Streptococcus infantarius supsp. infantarius, yet we were unable to get accurate results from the CSF culture. The fever subsided on the second day of hospitalization, and the patient was discharged without neurologic complication after 14 days of antibiotic therapy. In this case, we were able to accurately identify the pathogen using molecular genetic methods. To our knowledge, this is the first case of late onset neonatal bacteremia and meningitis caused by S. lutetiensis.
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