성인에서발생한 Lactococcus lactis subsp. lactis 카테터 관련 패혈성 쇼크 1예
A Case of Septic Shock Following Catheter-related Infection Caused by Lactococcus lactis subsp. lactis in an Adult
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Lactococcus lactis는 유산균의 발효에 광범위하게 이용되는 그람양성구균으로 특히 5개의 아종 중 L. lactis subsp. lactis에 의한 감염은 매우 드물게 보고되어 있다. 이에 저자들은 성인에서 발견된 L. lactis subsp. lactis에 의한 카테터감염 후 패혈쇼크로 진행한 증례를 보고하는 바이다. 요양병원에 입원하고 있던 64세 남성 환자가 일주일간 지속되는 발열, 오한을 주소로 외래를 경유하여 입원하였다. 환자는 이전에 받았던 수술에 의한 심한 장폐색증 이외에 특이소견은 없었으며, 요양병원에서 삽입하고 있던 말초삽입중심정맥관을 즉시 제거하였다. 말초혈액 2쌍 및 말초삽입중심정맥관의 카테터팁 배양을 실시한 결과, L. lactis subsp. lactis로 동정(Vitek 2, bioMerieux Inc., USA)되었고, 16S rRNA 유전자 염기서열분석결과도 일치하였다. 환자는 경험적 항생제인 ciprofloxacin을 투여하여 성공적으로 치료되었다.
Abstract
Lactococcus lactis is a gram-positive cocci used extensively in the dairy industry, but considered an unusual pathogen in humans. Among its five subspecies, L. lactis subsp. lactis in particular has rarely been reported as a pathogen. We report a case of septic shock caused by L. lactis subsp. lactis in an adult patient. A 64-yr-old male patient was admitted to outpatient clinics, with chief complaints of fever and chills for one week after convalescent hospital admission. He had severe ileus requiring surgery. He had a peripherally inserted central catheter from convalescent hospital, which was immediately removed. From two sets of blood and catheter tip cultures, we identified L. lactis subsp. lactis using the Vitek 2 system (bioMerieux Inc., USA), and confirmed this result by 16S rRNA sequencing. The patient was empirically treated with ciprofloxacin, and he recovered and was discharged.
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