A Case Series of Bacillus Cereus Septicemia in Patients with Hematological Disease
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- Uchino Yoshihito
- Department of Hematology and Rheumatology, Nihon University School of Medicine, Itabashi Hospital, Japan
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- Iriyama Noriyoshi
- Department of Hematology and Rheumatology, Nihon University School of Medicine, Itabashi Hospital, Japan
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- Matsumoto Ken
- Department of Clinical Laboratory, Nihon University School of Medicine, Itabashi Hospital, Japan
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- Hirabayashi Yukio
- Department of Hematology and Rheumatology, Nihon University School of Medicine, Itabashi Hospital, Japan
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- Miura Katsuhiro
- Department of Hematology and Rheumatology, Nihon University School of Medicine, Itabashi Hospital, Japan
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- Kurita Daisuke
- Department of Hematology and Rheumatology, Nihon University School of Medicine, Itabashi Hospital, Japan
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- Kobayashi Yujin
- Department of Hematology and Rheumatology, Nihon University School of Medicine, Itabashi Hospital, Japan
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- Yagi Mai
- Department of Hematology and Rheumatology, Nihon University School of Medicine, Itabashi Hospital, Japan
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- Kodaira Hitomi
- Department of Hematology and Rheumatology, Nihon University School of Medicine, Itabashi Hospital, Japan
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- Hojo Atsuko
- Department of Hematology and Rheumatology, Nihon University School of Medicine, Itabashi Hospital, Japan
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- Kobayashi Sumiko
- Department of Hematology and Rheumatology, Nihon University School of Medicine, Itabashi Hospital, Japan
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- Hatta Yoshihiro
- Department of Hematology and Rheumatology, Nihon University School of Medicine, Itabashi Hospital, Japan
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- Takeuchi Jin
- Department of Hematology and Rheumatology, Nihon University School of Medicine, Itabashi Hospital, Japan
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抄録
Objective Bacillus cereus (B. cereus) septicemia is a cause of life-threatening infection in patients with hematologic diseases. However, preventing a fatal prognosis in patients with B. cereus infection has not yet been achieved due to insufficient clinical investigations. To discover more optimal treatment strategies, we analyzed B. cereus septicemia in patients with hematologic diseases.<br> Methods At our institution, we observed 13 cases of B. cereus septicemia in 12 patients with hematologic diseases between January 2001 and September 2010. The susceptibility of B. cereus strains to antibiotics was also analyzed.<br> Results Of 12 patients, four died of B. cereus septicemia. In this study, the delayed administration of appropriate antibiotics (starting >24 hours after presentation), the presence of liver dysfunction and evidence of central nervous system (CNS) involvement tended to result in a fatal prognosis. All of the bacterial strains were found to be susceptible to vancomycin and quinolones (such as ciprofloxacin and levofloxacin), whereas many strains were resistant to clindamycin (76.9%) and imipenem (30.8%). In seven of 10 patients, central venous (CV) catheter tips were removed and routinely cultured. Catheter tip cultures were positive for B. cereus in three of seven patients.<br> Conclusion Although not specific to B. cereus bacteremia, patients who died of B. cereus tended to present with CNS symptoms and/or liver dysfunction. Our clinical data suggested that carbapenem and clindamycin are no longer appropriate choices for treating B. cereus. In addition, B. cereus septicemia was found to frequently originate from CV catheters. Constant attention must be paid to update assessments of antibiotic susceptibility and careful management must be applied to CV catheters in patients with hematologic diseases.<br>
収録刊行物
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- Internal Medicine
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Internal Medicine 51 (19), 2733-2738, 2012
一般社団法人 日本内科学会