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中华实验和临床感染病杂志(电子版)

中华实验和临床感染病杂志(电子版) ›› 2016, Vol. 10 ›› Issue (02) : 254 -256. doi: 10.3877/cma.j.issn.1674-1358.2016.02.026

病例报告

发热患者血液标本中Rothia aeria的分离鉴定与系统发育分析
曹敬荣1, 王培昌1,†(), 沈定霞2, 闵嵘1, 张丽丽1, 王育英1, 王岩1   
  1. 1. 100053　北京，首都医科大学宣武医院检验科
    2. 100084　北京，解放军总医院微生物科
  • 收稿日期:2015-02-27 出版日期:2016-04-15
  • 通信作者: 王培昌

Identification and phylogenetic analysis of Rothia aeria isolated from blood of a patient with fever

Jingrong Cao1, Peichang Wang1,†(), Dingxia Shen2, Rong Min1, Lili Zhang1, Yuying Wang1, Yan Wang1   

  1. 1. Department of Clinical Laboratory, Xuanwu Hospital of Capital Medical University, Beijing 100053, China
    2. Department of Microbiology, Chinese PLA General Hospital, Beijing 100853, China
  • Received:2015-02-27 Published:2016-04-15
  • Corresponding author: Peichang Wang
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曹敬荣, 王培昌, 沈定霞, 闵嵘, 张丽丽, 王育英, 王岩. 发热患者血液标本中Rothia aeria的分离鉴定与系统发育分析[J]. 中华实验和临床感染病杂志(电子版), 2016, 10(02): 254-256.

Jingrong Cao, Peichang Wang, Dingxia Shen, Rong Min, Lili Zhang, Yuying Wang, Yan Wang. Identification and phylogenetic analysis of Rothia aeria isolated from blood of a patient with fever[J]. Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition), 2016, 10(02): 254-256.

目的

总结Rothia aeria血流感染的临床与实验室鉴定特点，为临床诊疗提供帮助。

方法

复习由该菌引起的血流感染病例，综合其形态学特征、生化特性、MALDI Biotyper质谱和16S rRNA序列相似性和系统发育分析对该菌进行分离培养、鉴定和药敏试验。

结果

Rothia aeria血流感染为国内首例（Genbank登录号为KF691779）报道，经质谱和16SrRNA可准确鉴定Rothia aeria。药敏试验结果显示其对左氧氟沙星、青霉素、氨苄西林、红霉素、庆大霉素、亚胺培南、哌拉西林和头孢他啶均敏感。临床根据药敏结果选用氨苄西林舒巴坦足量足疗程治疗，患者好转出院。

结论

Rothia aeria引起感染临床少见，16S rRNA和质谱能准确鉴定Rothia aeria，血培养对病原诊断有重要价值。

关键词: 血培养, Rothia aeria, 16S rRNA, 系统发育分析, MALDI Biotyper质谱
Objective

To investigate the clinical and laboratory features of bloodstream infection caused by Rothia aeria, and to supply better diagnosis and therapy.

Methods

The clinical diagnosis, treatments, outcomes and laboratory data, including blood culture, identification, antimicrobial susceptibility testing results were reviewed and analyzed, respectively. The bacterial identification was taken by 16S rRNA sequencing and MALDI Biotyper mass spectrometry.

Results

Rothia aeria bloodstream infection was the first report in China (Genbank login number for KF691779). MALDI Biotyper mass spectrometry and 16S rRNA gene sequencing could identify Rothia aeria accurately. The results of antimicrobial susceptibility testing by E-test method showed that levofloxacin, penicillin, ampicillin, erythromycin, gentamicin, imipenem, piperacillin and ceftazidime were all sensitive. Ampicillin/sulbactam were used with high-dose and long-term treatment, the patient was discharged.

Conclusions

The clinical infections caused by Rothia aeria are rare. 16S rRNA and MALDI Biotyper mass spectrometry could accurately identify Rothia aeria. Blood culture is of important value for pathogen detection.

Key words: Blood culture, Rothia aeria, 16S rRNA, Phylogenetic analysis, MALDI biotyper mass spectrometry
图1 革兰染色镜检结果（× 1 000）
图2 血平板5% CO2培养72 h结果
图3 16S rRNA基因系统发育树分析
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