WHATEVER

今天跟查房,主治講了一個有趣的細菌,俗名叫聖誕菌~~為什麼呢? 因為它可以拿來畫聖誕卡片喔!!! 

雖然用細菌畫卡片的想法還滿噁的,不過還是覺得很有趣啦^^

              紅色-Serratia marcescens

              綠色-Pseudomonas aeruginosa

              黃色-Stenotrophomonas maltophilia-->難殺的菌,但virulence不高,好發於immunocompromised pt

先來介紹一下主角吧~~Serratia marcescens

Serratia: opportunistic gram-negative bacteria classified in the tribe Klebsielleae and the large family Enterobacteriaceae

Serratia marcescens is the primary pathogenic species of Serratia.

Some strains of S marcescens are capable of producing a pigment called prodigiosin(橘紅色色素), which ranges in color from

dark red to pale pink, depending on the age of the colonies. S marcescens has a predilection for growth on starchy foodstuffs,

where the pigmented colonies are easily mistaken for drops of blood.

Site:  Nosocomial, catherter-associated infection, UTI

          Bathroom,親水性細菌

Resistant to Ampicillin, 第一代Cephalosporin, Macrolide

Case:   病人發現elbow處有一carbuncle，尋求中醫療法，敷蓋草藥於傷口處，幾天後紅腫熱痛加劇因而就醫。外科醫師debridement結果有許多

            紅色類似hematoma物質...但病人沒有trauma history，culture後判定為Serratia marcescens infection，改以Baktar (TMP-SMX) or Quinolone治療

Baktar complication:

1. Hypersensitivity: Steven-Johnson syndrome

This disorder is usually more severe than erythema muftiforme. In addition to erosion of multiple mucous membranes, small blisters develop on dusky or purpuric maculae. Fever and malaise also occur.-->epidermis & dermis separate

2. Agranulocytosis

3. Pseudo creatinine increase