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Streptococcus lutetiensis 에 의한 지발형 신생아 균혈증과 수막염 1례

A Case of Late Onset Neonatal Bacteremia and Meningitis Caused by Streptococcus lutetiensis

  • 김지숙 (고신대학교 의과대학 소아과학교실) ;
  • 홍유라 (고신대학교 의과대학 소아과학교실) ;
  • 양희영 (고신대학교 의과대학 진단검사의학교실) ;
  • 오지은 (고신대학교 의과대학 소아과학교실)
  • Kim, Ji Sook (Department of Pediatrics, Kosin University College of Medicine) ;
  • Hong, Yoo Ra (Department of Pediatrics, Kosin University College of Medicine) ;
  • Yang, Hee Yeong (Department of Laboratory Medicine, Kosin University College of Medicine) ;
  • Oh, Chi Eun (Department of Pediatrics, Kosin University College of Medicine)
  • 투고 : 2014.05.09
  • 심사 : 2014.07.07
  • 발행 : 2014.12.25

초록

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.

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.

키워드

참고문헌

  1. Chapter 11. Disease of the Newborn. In: Ahn HS, editor. Hong Changeui Textbook of Pediatrics. 10th ed. Seoul: Mirae-N Co., Ltd, 2012:331-6.
  2. Heading DL, Herrera A, Mazzi E, Bergman MA. Fulminant neonatal septicemia caused by Streptococcus bovis. J Pediatr 1978;92:282-3. https://doi.org/10.1016/S0022-3476(78)80026-2
  3. Schlegel L, Grimont F, Ageron E, Grimont PA, Bouvet A. Reappraisal of the taxonomy of the Streptococcus bovis/Streptococcus equinus complex and related species: description of Streptococcus gallolyticus subsp. gallolyticus subsp. nov., S. gallolyticus subsp. macedonicus subsp. nov. and S. gallolyticus subsp. pasteurianus subsp. nov. Int J Syst Evol Microbiol 2003;53:631-45. https://doi.org/10.1099/ijs.0.02361-0
  4. Park JW, Kim YK, Eun SH, Kim EC, Seong MW. Neonatal invasive Streptococcus gallolyticus subsp. pasteurianus infection with delayed central nervous system complication. Korean J Pediatr 2013 in Press.
  5. Gerber JS, Glas M, Frank G, Shah SS. Streptococcus bovis infection in young infants. Pediatr Infect Dis J 2006;25:1069-73. https://doi.org/10.1097/01.inf.0000240334.91713.48
  6. Grant RJ, Whitehead TR, Orr JE. Streptococcus bovis meningitis in an infant. J Clin Microbiol 2000;38:462-3.
  7. Cheung M, Pelot M, Nadarajah R, Kohl S. Neonate with late onset Streptococcus bovis meningitis: case report and review of the literature. Pediatr Infect Dis J 2000;19:891-3. https://doi.org/10.1097/00006454-200009000-00019
  8. Okumura A, Takahashi H, Ogawa A, Kuno K, Watanabe K. Streptococcus bovis meningitis in an otherwise healthy infant. Clin Pediatr (Phila) 2002;41:523-4. https://doi.org/10.1177/000992280204100711
  9. Koh TH, Ho S. Streptococcus bovis meningitis in a neonate with Ivemark syndrome. Scand J Infect Dis 2002;34:63-4. https://doi.org/10.1080/00365540110076958
  10. Al-Arishi H, Frayha HH, Yaneza AL, Al Hifzi IS. Isolated cerebrospinal fluid eosinophilia due to Streptococcus bovis meningitis in an infant. Int J Infect Dis 2002;6:323-5. https://doi.org/10.1016/S1201-9712(02)90171-2
  11. Gavin PJ, Thomson RB Jr, Horng SJ, Yogev R. Neonatal sepsis caused by Streptococcus bovis variant (biotype II/2): report of a case and review. J Clin Microbiol 2003;41:3433-5. https://doi.org/10.1128/JCM.41.7.3433-3435.2003
  12. Onoyama S, Ogata R, Wada A, Saito M, Okada K, Harada T. Neonatal bacterial meningitis caused by Streptococcus gallolyticus subsp. pasteurianus. J Clin Microbiol 2009;58:1252.
  13. Khan A. Relative penicillin resistance in Streptococcus bovis. A case of neonatal meningitis. J Paediatr Child Health 2009;45:474-5. https://doi.org/10.1111/j.1440-1754.2009.01541.x
  14. Kaltte JM, Clarridge JE 3rd, Bratcher D, Selvarangan R. A longitudinal case series description of meningitis due to Streptococcus gallolyticus subsp. pasteurianus in infants. J Clin Microbiol 2012;50:57-60. https://doi.org/10.1128/JCM.05635-11
  15. Thatrimontrichai A, Chanvitan P, Janjindamai W, Dissaneevate S, Maneenil G. Early onset neonatal bacterial meningitis caused by Streptococcus gallolyticus subsp. pasteurianus. Southeast Asian J Trop Med Public Health 2012;43:145-51.
  16. Nagamatsu M, Takagi T, Ohyanagi T, Yamazaki S, Nobuoka S, Takemura H, et al. Neonatal bacterial meningitis caused by Streptococcus gallolyticus subsp. pasteurianus. J Infect Chemother 2012;18:265-8. https://doi.org/10.1007/s10156-011-0320-4
  17. Binghuai L, Wenjun S, Xinxin L. Intrauterine infection and post-partum bacteraemia due to Streptococcus gallolyticus subsp. pasteurianus. J Med Microbiol 2013;62:1617-9. https://doi.org/10.1099/jmm.0.054106-0
  18. Takahashi Y, Ishiwada N, Tanaka J, Okusu K, Ichimura S, Hishiki H, et al. Streptococcus gallolyticus subsp. pasteurianus meningitis in an infant. Pediatr Int 2014;56:282-5. https://doi.org/10.1111/ped.12254
  19. Floret N, Bailly P, Thouverez M, Blanchot C, Alez-Martin D, Menget A, et al. A cluster of bloodstream infections caused by Streptococcus gallolyticus subspecies pasteurianus that involved 5 preterm neonates in a university hospital during a 2-month period. Infect Control Hosp Epidemiol 2010;31:194-6. https://doi.org/10.1086/650380
  20. Nagai K, Gotoh K, Hirotaki S, Hidaka H, Koga H, Ikenaga M, et al. A case of bacterial meningitis due to Streptococcus bovis in an infant with normal cerebrospinal fluid findings at the first CSF examination. Kansenshogaku Zasshi 2008;82:26-9. https://doi.org/10.11150/kansenshogakuzasshi1970.82.26
  21. Beck M, Frodl R, Funke G. Comprehensive study of strains previously designated Streptococcus bovis consecutively isolated from human blood cultures and emended description of Streptococcus gallolyticus and Streptococcus infantarius subsp. coli. J Clin Micorobiol 2008;46:2966-72. https://doi.org/10.1128/JCM.00078-08
  22. Schlegel L, Grimont F, Collins MD, Regnault B, Grimont PA, Bouvet A. Streptococcus infantarius sp. nov., Streptococcus infantarius subsp. infantarius subsp. nov. and Streptococcus infantarius subsp. coli subsp. nov., isolated from humans and food. Int J Syst Evol Microbiol 2000;50:1425-34. https://doi.org/10.1099/00207713-50-4-1425
  23. Romero B, Morosini MI, Loza E, Rodriguez-Banos M, Navas E, Canton R, et al. Reidentification of Streptococcus bovis isolates causing bacteremia according to the new taxonomy criteria: still an issue? J Clin Microbiol 2011;49:3228-33. https://doi.org/10.1128/JCM.00524-11
  24. Janda JM, Abbott SL. 16S rRNA gene sequencing for bacterial identification in the diagnostic laboratory: pluses, perils, and pitfalls. J Clin Microbiol 2007;45:2761-4. https://doi.org/10.1128/JCM.01228-07
  25. Haanpera M, Jalava J, Huovinen P, Meurman O, Rantakokko-Jalava K. Identification of alpha-hemolytic streptococci by pyrosequencing the 16S rRNA gene and by use of VITEK 2. J Clin Microbiol 2007;45:762-70. https://doi.org/10.1128/JCM.01342-06
  26. Fikar CR, Levy J. Streptococcus bovis meningitis in a neonate. Am J Dis Child 1979;133:1149-50.

피인용 문헌

  1. Streptococcus lutetiensis neonatal meningitis with empyema vol.3, pp.9, 2021, https://doi.org/10.1099/acmi.0.000264