Vibrio vulnificus에 의한 원발성 창상감염 1예

Abstract

Edwardsiella tarda, a recently described member of the family Enterobacteriaceae, exsists widely in nature, being isolated from fish, lizards, alligators, snakes, sea mammals, cattle, swine, and the environment. However, human infections due to E. tarda have been reported only infrequently. Although the most common infection due to E. tarda is gastroenteritis, a number of serious wound infection, liver abscess, cholangitis, bacteremia, and meningitis have been reported. There has been no previous report of E. tarda "isolated" from clinical specimen in Korea. We report the first case of E. tarda infection in a 78-ydar old female with fatal bacteremia, multiple liver abscess and cholangitis. The isolate from blood specimen was facultative anaerobic gram-negative rods that were colorless on MacConkey and salmonella-shigella agar media and translucent, surrounded by a small zone of clear hemolysis on blood agar. It was motile at 25℃ and 37℃ and K/A with the formation of H2S in TSI agar. In biochemical reaction, catalase, nitrate reduction, indole, methyl red, ornithine and lysine decarboxylase were positive, but oxidase, VP, citrate, and urea were negative. Acid and gas were produced from glucose and maltose in 24hr. It was resistant to erythromycin and neomycin, moderately sensitive to kanamycin and streptomycin, and sensitive to penicillin, colistin, ampicillin, carbenicillin, cephalothin, choloramphenicol, gentamcin, nalidixic acid, polymyxin B, tetracycline, tobramycin, sulfamethoxazole-trimethoprim, ciprofloxacin and norfloxacin in antimicrobial susceptibility tests.