RESUMO
A blood smear examination led to the diagnosis of severe bacterial infection in a splenectomized patient. The knowledge of a relevant clinical information (recent dog bite) could have led to immediate presumptive identification of the causative agent, Capnocytophaga canimorsus.
Assuntos
Mordeduras e Picadas/complicações , Capnocytophaga/isolamento & purificação , Cães , Infecções por Bactérias Gram-Negativas/diagnóstico , Choque Séptico/diagnóstico , Animais , Bacteriemia/diagnóstico , Bacteriemia/etiologia , Bacteriemia/microbiologia , Mordeduras e Picadas/diagnóstico , Mordeduras e Picadas/microbiologia , Citodiagnóstico , Testes Diagnósticos de Rotina , Infecções por Bactérias Gram-Negativas/sangue , Infecções por Bactérias Gram-Negativas/etiologia , Infecções por Bactérias Gram-Negativas/microbiologia , Testes Hematológicos , Humanos , Masculino , Pessoa de Meia-Idade , Choque Séptico/sangue , Choque Séptico/etiologia , Choque Séptico/microbiologia , EsplenectomiaRESUMO
We previously reported the distribution of Achromobacter spp. (species and Sequence Types (ST)) in our French Cystic Fibrosis (CF) centre. In the present study we collected 109 Achromobacter isolates (1/patient) from 9 other French CF Centres for species identification, antimicrobial susceptibility testings and Multilocus-Sequence-Typing (MLST) analysis. Ten species were detected, A. xylosoxidans being the most predominant one (73.4% of the isolates). Piperacillin-tazobactam, ceftazidime, imipenem, meropenem and ciprofloxacin were respectively active against 88, 70, 79, 72 and 23% of the isolates. Among the 79 A. xylosoxidans isolates, 46 STs were detected. Interestingly, ST 137, recovered in 4 centres (5 patients), was previously detected in our centre (2 patients). The strains from the 7 patients belonged to the same pulsotype (pulsed-field-gel-electrophoresis analysis) and harboured acquired resistance to meropenem, ceftazidime, ciprofloxacin, and except for 2 isolates, to imipenem and piperacillin-tazobactam. This is the first description in France of a circulating multiresistant A. xylosoxidans strain.