급성 골수성 백혈병환자에서 발생한 중심정맥관 관련Mycobacterium mucogenicum 균혈증 1예
Central catheter-related bloodstream infection caused by Mycobacterium mucogenicum in an acute myeloid leukemia patient
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Mycobacterium mucogenicum은 색소를 형성하지 않는 신속발육 항산균의 일종으로 드물게 상처 관련 감염이나 중심 정맥관 균혈증을 일으킬 수 있다. 중심 정맥관을 가지고 있었던 면역기능 저하 환자의 혈액배양 여러 쌍에서 그람 양성 간균이 자랄 때 가능성을 염두에 두어야 하며 정확한 진단과 치료를 위해서는 16S RNA 염기서열 분석 등의 분자생물학적 기법을 이용하여 신속히 동정하는 것이 바람직하다. 저자들은 급성 골수성 백혈병으로 히크만 중심 정맥관을 가지고 있던 환자에서 발열이 있어 시행한 혈액배양 검사상 자란 신속 발육 항산균을 16S RNA를 이용하여 M. mucogenicum으로 신속히 동정하였고, cefoxitin과 amikacin을 투여하여 치유하였기에 문헌고찰과 함께 보고하는 바이다.
Abstract
Mycobacterium mucogenicum is the one of rapidly growing mycobacteria identified in 1995; so far, only few cases have been reported that were associated with dialysis equipment or central venous catheter. Here we present a central catheter-related M. mucogenicum bloodstream infection in a 48-year-old woman with acute myeloid leukemia. She presented with fever and was empirically treated with ceftazidime and piperacillin. Since the fever resolved within 24 hours, she underwent bone marrow transplantation as scheduled. Four days before stem cell infusion, M. mucogenicum grew from the blood cultures that were drawn through a central venous catheter and from peripheral blood. The central venous catheter was removed and the cultured organism was identified to be M. mucogenicum by sequence analysis of the 16S ribosomal RNA. She was further treated for 8 weeks with cefoxitin and amikacin as the bacteria were confirmed to be susceptible by broth microdilution test. There has been no episode of recurrence during the 6-month follow-up.(Korean J Med 71:582-586, 2006)
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