C Elif ÖZTÜRK, Ahmet ŞAHİN, Harun GÜNEŞ, Fatma AVCIOĞLU

Mastit Sonrası Gelişen Penisilin Dirençli Aerococcus Viridans Bakteremisi

Aerococcus viridans, Gram pozitif, mikroaerofilik, katalaz ve oksidaz negatif, hareketsiz birkoktur. Çoğunlukla saprofit olup, nadiren bakteremiye ve fırsatçı enfeksiyonlara nedenolmaktadır. Bu raporda mastit ve ateş nedeniyle acile başvuran 28 yaşında postpartumlaktasyonda olan hastada, Aerococcus viridans‘ın neden olduğu nadir bir bakteremi olgususunulmaktadır. Hastadan kan kültürleri alındıktan sonra ampirik olarak seftriakson tedavisibaşlanmıştır. Kan kültüründe üreyen Gram pozitif kok morfolojisindeki katalaz negatif bakteriAerococcus viridans olarak tanımlanmıştır. İzolatın Gram ile boyanmasında, tetrat yapan koklargörülmüş, koyun kanlı agarda alfa-hemolitik koloniler saptanmıştır. Kirby-Bauer disk difüzyonmetodu ile yapılan antibiyotik duyarlılık testinde, penisilin ve eritromisin dirençli, klindamisin,vankomisin, teikoplanin, kloramfenikol, ampisilin, sefotaksim, seftriakson, linezolid veofloksasin duyarlı olduğu tespit edilmiştir. Olgu, seftriakson (2 x 1 g/gün) ile başarıyla tedaviedilmiş ve komplikasyonsuz olarak iyileşmiştir. Sonuç olarak, Aerococcus viridans‘ınpostpartum laktasyon döneminde mastit enfeksiyonu etkeni olabileceği akılda tutulmalı veantibiyotik duyarlılık testlerine göre tedavi uygulanmalıdır

Anahtar Kelimeler:

Aerococcus viridans, bakteremi, mastit

Post-Mastitis Bacteremia Caused by Penicillin-Resistant Aerococcus Viridans

Aerococcus viridans is a coccus that is Gram positive, microaerophylic, catalase and oxidasenegative, non-motile. It is mostly saprophytic but it may rarely cause opportunistic infectionsand bacteremia. A rare bacteremia case caused by Aerococcus viridans in a 28 year-old patientwho was in post-partum lactation period and admitted to emergency room due to mastitis andfever was presented in this report. Ceftriaxone treatment was started empirically after bloodcultures of patient had been taken. A bacteria which was Gram positive, catalase, and oxidasenegative, and in the form of a coccus morpholocillay was isolated in blood cultures and it wasidentified as Aerococcus viridans. When the isolate was stained with Gram stain, cocci formingtetrades were seen and alpha hemolytic colonies were detected on sheep blood agar. It was foundto be resistant to penicillin, and erythromycin, and susceptible to clindamycin, vancomycin,teicoplanin, cloramphenicol, ampicillin, cefotaxime, ceftriaxone, linesolide, and ofloxacine withantibiotic susceptibility test using Kirby-Bauer disc diffusion method.The case was succesfullytreated with ceftriaxone (2 X 1 g/day) and completely recovered without any complication. Inconclusion, it sould be remembered that Aerococcus viridans may be the causitive agent ofmastitis in post-partum lactation period, and the treatment should be directed according to resultsof antibiotic susceptibility tests

Keywords:

Aerococcus viridans, bacteremia, mastitis,

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