Elif OĞUZMAN, Hikmet ÇETİN, Mahmut KALEM, Ebru US, Zeynep Ceren KARAHAN, Ebru EVREN

Bacillus Cereus’un Etken Olduğu Travma İlişkili Yara Enfeksiyonu

Bacillus cereus, toprak, toz ve çamur, çürüyen organik madde, tatlı ve tuzlu sular, sebzeler ve fomitler de dahil olmak üzere doğada yaygın olarakbulunan, aerobik, endospor oluşturan Gram-pozitif çomaktır. Klinik örneklerden izole edildiğinde genellikle “kontaminant” olarak yorumlanır. Ancakhem gastrointestinal hem de ekstraintestinal enfeksiyonlarda etken olarak da bulunabilmektedir. Bu olgu sunumunda, ateşli silah yaralanmasısonucu gelişen tibia ve fibula kırığı nedeniyle opere edilen 35 yaşında diyabetik erkek hastada gelişen ve B. cereus’un etken olduğu post-travmatikyara enfeksiyonu sunulmuştur. B. cereus laboratuvarda her zaman kontaminant olarak kabul edilmemeli ve post-operatif ve post-travmatik yaraenfeksiyonlarında etken olarak akılda bulundurulmalıdır.

Traumatic Wound Infection Caused By Bacillus Cereus

Bacillus cereus is an aerobic, endospore-forming Gram-positive rod found widely in nature, including soil, dust and mud, rotting organic matter, fresh and salt water, vegetables and fomites. When isolated from clinical specimens it is often interpreted as a “contaminant”. However, it may present as an etiological agent in both gastrointestinal and extraintestinal infections. In this case report, we have presented a post-traumatic wound infection due to B. cereus in a 35 year-old, diabetic patient who have applied to hospital with gunshot injury and operated due to tibia and fibula fractures. B. cereus should not always be considered as a contaminant when cultured in the laboratory and should be kept in mind as a pathogen especially post-operative and post-traumatic wound infections.

PDF

___

1. Ehling-Schulz M, Koehler TM, Lereclus D. The Bacillus cereus group: Bacillus species with pathogenic potential. Microbiology spectrum. 2019;7.
2. Drobniewski FA. Bacillus cereus and related species. Clinical microbiology reviews. 1993;6:324-338.
3. Procop GW, Church D, Hall G, Janda W. Koneman’s Color Atlas and Textbook of Diagnostic: Philadelphia: Wolters Kluwer; 2017.
4. The European Committee on Antimicrobial Susceptibility Testing. Breakpoint tables for interpretation of MICs and zone diameters. Version 8.1, 2018. http://www.eucast.org.
5. Kotiranta A, Lounatmaa K, Haapasalo M. Epidemiology and pathogenesis of Bacillus cereus infections. Microbes and infection. 2000;2:189-198.
6. Bottone EJ. Bacillus cereus, a volatile human pathogen. Clinical microbiology reviews. 2010;23:382-398.
7. Åkesson A, Hedströum SÅ, Ripa T. Bacillus cereus: a significant pathogen in postoperative and post-traumatic wounds on orthopaedic wards. Scandinavian journal of infectious diseases. 1991;23:71-77.
8. Krause A, Freeman R, Sisson P, Murphy O. Infection with Bacillus cereus after close-range gunshot injuries. Journal of Trauma and Acute Care Surgery. 1996;41:546-548.
9. Dubouix A, Bonnet E, Alvarez M, Bensafi H, Archambaud M, Chaminade B, et al. Bacillus cereus infections in traumatology–orthopaedics department: retrospective investigation and improvement of healthcare practices. Journal of infection. 2005;50:22-30.
10. Dryden M. Pathogenic role of Bacillus cereus in wound infections in the tropics. Journal of the Royal Society of Medicine. 1987;80:480-481.
11. Darbar A, Harris IA, Gosbell IB. Necrotizing infection due to Bacillus cereus mimicking gas gangrene following penetrating trauma. Journal of orthopaedic trauma. 2005;19:353-355.
12. Johnson DA, Aulicino P, Newby JG. Bacillus cereus-induced myonecrosis. The Journal of trauma. 1984;24:267-270.
13. Ikeda M, Yagihara Y, Tatsuno K, Okazaki M, Okugawa S, Moriya K. Clinical characteristics and antimicrobial susceptibility of Bacillus cereus blood stream infections. Annals of clinical microbiology and antimicrobials. 2015;14:43.