Medical principles and practice : international journal of the Kuwait University, Health Science Centre · 2008
Pantoea agglomerans bloodstream infection in preterm neonates.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
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Aly Nasser Yehia A, Salmeen Hadeel N, Lila Reda A Abo, Nagaraja Prem A
Аннотация
OBJECTIVE: To report an uncommon incidence of sporadic bloodstream infection (BSI) caused by Pantoea agglomerans in preterm neonates.
CASE PRESENTATION AND INTERVENTION: Fives cases of nosocomial BSI with P. agglomerans in preterm neonates (weight <or=1,500 g; age 8-17 days; gestational age 26-30 weeks) are presented. All cases were late onset neonatal sepsis (>7 days of age). Lethargy, skin mottling and bradycardia were often present. Although there was no evidence of pneumonia, desaturation was a common feature. Thrombocytopenia developed in 4 patients, metabolic acidosis in 2 and jaundice in 2. No bleeding tendency or disseminating intravascular coagulation was recorded. Organisms cultured from blood were identified by the Vitek-2 system (bioMérieux, France) and the findings confirmed by testing the isolate on the API 20E system. All isolates shared in vitro susceptibility to gentamicin, amikacin, ciprofloxacin, piperacillin/tazobactam and meropenem. One patient was treated with a cefotaxime/amikacin combination, 2 with meropenem and the remaining 2 with tazocin. All patients responded well to antibiotic treatment and survived.
CONCLUSION: P. agglomerans is an unusual pathogen in the etiology of neonatal sepsis. Despite significant clinical deterioration, early detection and proper antibiotic therapy carry a favorable outcome.
CASE PRESENTATION AND INTERVENTION: Fives cases of nosocomial BSI with P. agglomerans in preterm neonates (weight <or=1,500 g; age 8-17 days; gestational age 26-30 weeks) are presented. All cases were late onset neonatal sepsis (>7 days of age). Lethargy, skin mottling and bradycardia were often present. Although there was no evidence of pneumonia, desaturation was a common feature. Thrombocytopenia developed in 4 patients, metabolic acidosis in 2 and jaundice in 2. No bleeding tendency or disseminating intravascular coagulation was recorded. Organisms cultured from blood were identified by the Vitek-2 system (bioMérieux, France) and the findings confirmed by testing the isolate on the API 20E system. All isolates shared in vitro susceptibility to gentamicin, amikacin, ciprofloxacin, piperacillin/tazobactam and meropenem. One patient was treated with a cefotaxime/amikacin combination, 2 with meropenem and the remaining 2 with tazocin. All patients responded well to antibiotic treatment and survived.
CONCLUSION: P. agglomerans is an unusual pathogen in the etiology of neonatal sepsis. Despite significant clinical deterioration, early detection and proper antibiotic therapy carry a favorable outcome.