Olgu sunumu: Akut lenfoblastik lösemi tanısıyla tedavi edilen hastada gelişen kateter ilişkili Ochrobactrum antropi bakteriyemisi

Yıl 2017, Cilt: 74 Sayı: 1, 79 - 82, 01.03.2017

Güliz Doğan Nisel Yılmaz Neval Ağuş Fatma Burcu Belen Barış Malbora Pınar Şamlıoğlu Sevgi Yılmaz Hancı Yeşer Karaca Derici Mümtaz Cem Şirin Arzu Bayram

Öz

Sunulan olgu, pre-B hücreli ALL akut lenfoblastik lösemi tanısıyla kemoterapi alan dört yaşındaki kız çocukta gelişen kateter ilişkili Ochrobactrum antropi O. antropi bakteriyemisidir. Hastaya kemoterapi öncesi kateter takılmıştır. Verilen kemoterapiden sonra 38,5 oC ateşi başlayan hastaya nötropenik ateş tanısı konmuş, eş zamanlı olarak periferden ve kateterden kan kültürü alınmıştır. Birinci, ikinci ve dördüncü gün kateterden alınan kan kültürlerinde BacT/ALERT 3D, bioMerieux, Fransa üreme saptanırken, aynı günlerde eş zamanlı olarak periferden alınan kan kültürlerinde üreme olmamıştır. Bakterinin tanımlanması, eş zamanlı olarak VITEK 2 bioMerieux, Fransa ve BD Phoenix 100 Becton Dickinson, USA otomatize sistemleriyle yapılmış ve O. antropi tespit edilmiştir. Kültür antibiyogramında imipenem ve meropeneme duyarlı; sefepim, piperasilin-tazobaktam, sefoperazonsulbaktam, amikasin, trimetoprim-sulfametoksazol, siprofloksasin, saptanmıştır. Hastadan beşinci ve altıncı gün alınan kateter kültürlerinde üreme saptanmamıştır. O. antropi’nin özellikle immün sistemi baskılı hastalarda kateterle ilişkili enfeksiyonlarda etken olabileceği akla getirilmelidir

Anahtar Kelimeler

akut lenfoblastik lösemi, Ochrobactrum antropi, kateter ilişkili bakteriyemi

Case report: catheter-related Ochrobacturm antropi bacteraemia developed in patient with acute lymphoblastic leukemia who is taking chemotherapy.

Öz

It was reported on the case history of catheter related Ochrobacturm antropi O. antropi bacteraemia developed in four years old girl with pre-B cell ALL acute lymphoblastic leukemia who is taking chemotherapy. At the start of chemotherapy babyport portacath was implanted. The patient who had 38.5 oC fever after block chemotherapy was diagnosed as neutropenic fever and simultaneously peripheral and catheter blood cultures BacT/ALERT 3D, bioMerieux, France were taken. The first, second and fourth days of blood cultures taken from catheter were positive, whereas peripheral blood cultures were negative simultaneously. VITEK 2 bioMerieux, Fransa and BD Phoenix 100 Becton Dickinson, USA automated systems were used to identification of bacteria, and O. antropi was identified. The isolate was susceptible to imipenem and meropenem, and resistant to cefepime, piperacillin-tazobactam, cefoperazonsulbactam, amikacin, trimethoprim-sulfamethoxazole, ciprofloxacin, ofloxacin, levofloxacin. The cultures were negative on the fifth and sixth days of therapy therefore the catheter was not removed. O. antropi should be considered as agent pathogen with catheter related infection especially in the immuno compromised patients.Key Words: acut lymphoblastic leukemia, Ochrobactrum antropi, catheter related bacteraemia

Anahtar Kelimeler

acut lymphoblastic leukemia, Ochrobactrum antropi, catheter related bacteraemia

Kaynakça

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