谢贵明,陈锦蓉

产气荚膜梭菌是一种环境、动物和人类肠道中常见的革兰阳性厌氧杆菌，有研究表明，产气荚膜梭菌能引起罕见的血流感染，尤其在免疫功能低下的个体，特别是肿瘤相关放、化疗患者中[1]。而葡萄糖6-磷酸脱氢酶（G6PD）缺乏症是一种酶缺陷疾病，这种病症的人患上感染的风险也会增加。原因是G6PD缺乏症患者容易受到氧化应激的影响，从而导致细胞受损、氧化应激增加以及溶血的发生[2]。此外，免疫系统功能减弱也会增加感染的风险。因此，该篇文章报道了一位女性患者，她有过肿瘤手术的历史，并且在其血液样本中检测到了产气荚膜梭菌的存在，这暗示G6PD缺乏症可能与感染有一定的关联。

G6PD缺乏症；产气荚膜梭菌；急性溶血

[1] 刘淑芬,胡秀华.血液标本中分离产气荚膜梭菌1例的报道[J].国际检验医学杂志,2017,38(02):287-8. [2] HWANG S,MRUK K,RAHIGHI S,et al.Correcting glucose-6-phosphate dehydrogenase deficiency with a small-molecule activator[J].Nat Commun,2018,9(1):4045. [3] SIMON T G,BRADLEY J,JONES A,et al.Massive intravascular hemolysis from Clostridium perfringens septicemia:a review[J].J Intensive Care Med,2014,29(6):327-33. [4] SAKAUE M,OTA K,NAKAMURA E,et al.Type A fulminant Clostridium perfringens sepsis indicated RBC/Hb discrepancy;a case report[J].BMC Infect Dis,2019,19(1):719. [5] CHEN K,AHMED S,SHENG Y J,et al.Diagnostic Accuracy of Nucleic Acid Amplification-Based Assays for Clostridium perfringens-Associated Diseases:a Systematic Review and Meta-analysis[J].J Clin Microbiol,2020,58(9). [6] CHINEN K.Sudden death caused by Clostridium perfringens sepsis presenting as massive intravascular hemolysis[J].Autops Case Rep,2020,10(3):e2020185. [7] RECHT J,ASHLEY E A,WHITE N J.Use of primaquine and glucose-6-phosphate dehydrogenase deficiency testing:Divergent policies and practices in malaria endemic countries[J].PLoS Negl Trop Dis,2018,12(4):e0006230. [8] NAVARRO M A,MCCLANE B A,UZAL F A.Mechanisms of Action and Cell Death Associated with Clostridium perfringens Toxins[J].Toxins(Basel),2018,10(5). [9] HOSHI Y,TAKESHIMA K,MATSUOKA S,et al.Survival in a Case of Emphysematous Cholecystitis With Sepsis Caused by Clostridium perfringens[J].Cureus,2023,15(11):e49705. [10] 隋晓露,刘新华,杨文君,et al.不同血液净化模式治疗多器官功能衰竭犬对单核细胞功能影响的对比研究[J].中华实用诊断与治疗杂志,2017,31(12):1148-51.

点击下载PDF