DOI QR코드

DOI QR Code

A Case of Vertebral Osteomyelitis Caused by Serratia grimesii in a Patient without Predisposing Factors

위험인자가 없는 환자에서 발생한 Serratia grimesii에 의한 감염성 척추염 1예

  • Cheon, Shin-Hye (Division of Infectious Diseases, Chungnam National University Hospital) ;
  • Sohn, Kyung-Mok (Division of Infectious Diseases, Chungnam National University Hospital) ;
  • Kim, Yeon-Sook (Division of Infectious Diseases, Chungnam National University Hospital) ;
  • Jung, Hyeon (Division of Infectious Diseases, Chungnam National University Hospital) ;
  • Eun, Hyuk-Soo (Department of Internal Medicine, Chungnam National University Hospital) ;
  • Choi, Seung-Won (Department of Neurosurgery, Chungnam National University Hospital) ;
  • Koo, Sun-Hoe (Department of Laboratory Medicine, Chungnam National University Hospital)
  • 천신혜 (충남대학교병원 감염내과) ;
  • 손경목 (충남대학교병원 감염내과) ;
  • 김연숙 (충남대학교병원 감염내과) ;
  • 정현 (충남대학교병원 감염내과) ;
  • 은혁수 (충남대학교병원 내과) ;
  • 최승원 (충남대학교병원 신경외과) ;
  • 구선회 (충남대학교병원 진단검사의학과)
  • Published : 2012.07.01

Abstract

Vertebral osteomyelitis or paraspinal abscess caused by Serratia species is rare and has been reported only in certain groups of people, such as intravenous drug users, immunocompromised hosts, and patients who have undergone invasive procedures. However, we report here that Serratia was recovered from a patient with vertebral osteomyelitis and epidural abscess without predisposing factors. The organism was initially identified as Serratia liquefaciens by a Vitek II-based assessment. It was finally identified as Serratia grimesii by 16S rRNA gene sequence analysis. We present the first case of vertebral osteomyelitis caused by S. grimesii in a patient without risk factors and who was managed successfully.

Serratia에 의한 감염은 대부분 병원 시술이나 수술 혹은 면역 저하와 관련되어 있다. 인간 감염을 일으키는 것으로 S.marcescens가 가장 흔하고 S. liquefaciens도 종종 문제가 된다. 그러나 S. gimesii에 의한 감염 혹은 지역사회 획득 Serratia 척추염은 보고된 적이 없다. 저자들은 고혈압 외에는 건강하게 지내던 환자에서 발생한 경막외 고름을 동반한 S. grimesii에 의한 척추 골수염을 경험하였다. 고름 제거 후 항생제 치료로 호전되어 문헌고찰과 함께 보고하는 바이다.

Keywords

References

  1. Acar JF. Serratia marcescens infections. Infect Control 1986;7:273-278.
  2. Sohn KM, Ko KS, Kim J, et al. Identification of Gemella species by 16S ribosomal RNA gene sequencing from two patients with infective endocarditis. Korean J Med 2006;70:591-596.
  3. Stock I, Grueger T, Wiedemann B. Natural antibiotic susceptibility of strains of Serratia marcescens and the S. liquefaciens complex: S. liquefaciens sensu stricto, S. proteamaculans and S. grimesii. Int J Antimicrob Agents 2003;22:35-47.
  4. Hejazi A, Falkiner FR. Serratia marcescens. J Med Microbiol 1997;46:903-912. https://doi.org/10.1099/00222615-46-11-903
  5. Weinstein MA, McCabe JP, Cammisa FP Jr. Postoperative spinal wound infection: a review of 2,391 consecutive index procedures. J Spinal Disord 2000;13:422-426. https://doi.org/10.1097/00002517-200010000-00009
  6. Hadjipavlou AG, Gaitanis IN, Papadopoulos CA, Katonis PG, Kontakis GM. Serratia spondylodiscitis after elective lumbar spine surgery: a report of two cases. Spine (Phila Pa 1976) 2002;27:E507-E512. https://doi.org/10.1097/00007632-200212010-00018
  7. Alfonso Olmos M, Silva González A, Duart Clemente J, Villas Tomé C. Infected vertebroplasty due to uncommon bacteria solved surgically: a rare and threatening life complication of a common procedure: report of a case and a review of the literature. Spine (Phila Pa 1976) 2006;31:E770-E773. https://doi.org/10.1097/01.brs.0000240202.91336.99
  8. Marques N, Sa R, Coelho F, da Cunha S, Melico-Silvestre A. Spondylodiscitis associated with recurrent Serratia bacteremia due to a transjugular intrahepatic portosystemic shunt (TIPS): a case report. Braz J Infect Dis 2007;11:525-527.
  9. Ashby ME. Serratia osteomyelitis in heroin users: areport of two cases. J Bone Joint Surg Am 1976;58:132-134.
  10. Mahlen SD, Morrow SS, Abdalhamid B, Hanson ND. Analyses of ampC gene expression in Serratia marcescens reveal new regulatory properties. J Antimicrob Chemother 2003;51:791-802. https://doi.org/10.1093/jac/dkg133