肝硬化失代偿期患者并发解没食子酸链球菌血流感染1例

解没食子酸链球菌是革兰阳性D族链球菌，属牛链球菌/马链球菌复合群。该菌为机会性致病菌，可引起多部位、多脏器感染，但肝硬化失代偿期患者并发解没食子酸链球菌血流感染的报道较为少见。本例患者因食入不洁食物后出现腹泻伴发热，在寒战、高热时留取血液培养，检出一株革兰阳性菌，经生化实验分析和16S rRNA基因测序，确认为解没食子酸链球菌解没食子酸亚种。根据药敏试验结果，调整抗感染方案，给予美罗培南0.5 g q8h 静脉滴注7 d后，序贯左氧氟沙星0.5 g qd巩固治疗7 d，患者体温恢复正常后出院，随访无复发。

A case of bloodstream Streptococcus gallolyticus infection in a decompensated cirrhotic patient

Streptococcus gallolyticus (S. gallolyticus) is a Gram-positive group D streptococcus, belonging to Streptococcus bovis/Streptococcus equinus complex (SBSEC). This bacterium is an opportunistic pathogen that can cause infections in multiple sites and organs. However, the reports of bloodstream infection caused by S gallolyticus in patients with decompensated cirrhosis are rare. In this case, the patient developed diarrhea and fever after eating unclean food. Blood culture was obtained during chills and fever, and a strain of Gram-positive bacteria was isolated. The biochemical methods and 16S rRNA gene sequencing were used to identify the bacterial strain as Streptococcus gallolyticus subsp. gallolyticus. According to the results of antimicrobial susceptibility test, the patient was given meropenem 0.5 g q8h for 7 days and levofloxacin 0.5 g qd for another 7 days. The patient’s temperature returned to normal after the treatment.