재택 자가 항생제 치료 중이던 환아에서 발생한 중심정맥관 관련 Tsukamurella inchonensis 균혈증 1예
A Case of Catheter-Related Bloodstream Infection by Tsukamurella inchonensis in a Pediatric Patient Receiving Home Intravenous Antibiotic Treatment
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초록
Tsukamurella 속은 산소성으로 약한 항산성을 띠며 가지를 치지 않는 그람양성 막대균이다. Tsukamurella 균속이 중심정맥관관련 균혈증을 일으킨 예가 보고되어 있으며, Corynebacterium 이나 비정형 Mycobacterium로 잘못 동정되기도 하므로 이 균종의 감염은 실제보다 드물게 진단될 것으로 추정한다. 따라서 중심정맥관을 가진 환자에서 혈액배양에서 coryneform 그람양성막대균이 분리되어 중심정맥관관련 균혈증이 의심될 때 Tsukamurella 균종을 감별진단에 넣어야 할 것이다. 저자들은 담도폐쇄증으로간문-장문합술수술을 시행 받은 4세 환아에서 중심정맥관과 연관되어 발생한 T. inchonensis 균혈증을 보고하는 바이다.
Abstract
Bacteria belonging to the genus Tsukamurella are aerobic, gram-positive rods that are weakly acid-fast with no apparent branching. Infections of the Tsukamurella spp. are generally caused by the use of infected medical devices such as central venous catheters. The underreporting of these infections might be attributable to the frequent misdiagnosis of Tsukamurella infections as Corynebacterium or atypical Mycobacterium spp. infections. Therefore, when gram-positive aerobic rods are observed in the blood culture of a patient with a central venous catheter, it is important to consider Tsukamurella as one of the causative organisms. Here, we report the first case of a catheter-related blood stream infection caused by Tsukamurella inchonensis in a 3-yr-old Korean girl with underlying biliary atresia who underwent hepatoportoenterostomy.
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