中国感染控制杂志2024，Vol.23Issue(1)：86-94,9.DOI:10.12138/j.issn.1671-9638.20244484
中间普雷沃菌引起脊柱感染误诊分析及文献综述
Spinal infection caused by Prevotella intermedia:analysis of misdiagnosis and literature review
摘要
Abstract
Objective To explore the clinical characteristics and treatment scheme of patients with spinal infection caused by Prevotella intermedia(P.intermedia).Methods Clinical diagnosis and treatment processes of a patient with spinal infection caused by P.intermedia admitted to the spinal surgery department of a hospital were summa-rized,and relevant literature was retrieved from database for reviewing.Results The patient,a 50 year old male,was admitted to the hospital due to"lumbago pain complicated with pain in double lower extremities for 2 months".The lesion tissue was taken for metagenomic next-generation sequencing(mNGS)detection,which detected P.in-termedia,and the patient was diagnosed with P.intermedia spondylitis.After treatments with open lesion clea-rance,tube rinsing+autologous bone transplantation fusion internal fixation,intravenous drip of ceftriaxone sodium and metronidazole,as well as metronidazole rinsing,infection was under control.A total of 16 available papers were retrieved,together with this case,a total of 17 patients were included,with 7 males and 10 females.The main risk factors were diabetes and history of corticosteroid use(35.3％).The most common invasion sites were lumbar ver-tebra(n=12)and thoracic vertebra(n=6).13 cases were positive for pathogen culture,3 cases were positive for molecular detection,and 1 case was positive for staining microscopy.17 patients received anti-anaerobic bacteria treatment,with 14 cases receiving combined surgical treatment.One case died,with a mortality of 5.9％;5 cases had partial neurological impairment,with a disability rate of 29.4％.The survival rate of patients who received treatment of anti-anaerobic bacteria combined with surgery was 92.8％,3 patients only with anti-anaerobic bacteria treatment but without surgery were all cured.Conclusion P.intermedia is an opportunistic pathogeanic bacteria which often causes infection in immunocomprised individuals and is prone to be misdiagnosed.It is recommended to perform mNGS detection to identify the pathogen as early as possible and seize the opportunity for treatment to reduce mortality.关键词
普雷沃菌/脊柱炎/脊柱化脓性感染/误诊/宏基因组二代测序/mNGSKey words
Prevotella/spondylitis/spinal purulent infection/misdiagnosis/metagenomic next-generation sequencing/mNGS分类
医药卫生引用本文复制引用
王翀,杨义,李代君,范华华,鄢家强,王瑞春,蔡小军,蔡玉强,孙厚杰..中间普雷沃菌引起脊柱感染误诊分析及文献综述[J].中国感染控制杂志,2024,23(1):86-94,9.基金项目
遵义市科技计划项目[遵市科合HZ字(2022)46号] （2022）
贵州省科技计划课题[黔科合SY字(2015)3036] （2015）
