Case reports in pediatrics · 2026
Persistent Multidrug-Resistant Salmonella enterica Serovar Paratyphi A Bacteremia in a Preterm Neonate: A Case Report.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Sophea Khat, Viso Srey, Sophâl Chean
Аннотация
BACKGROUND: Neonatal sepsis caused by Salmonella enterica serovar Paratyphi A is rare and may present with nonspecific clinical features. Multidrug-resistant strains pose substantial diagnostic and therapeutic challenges, particularly in resource-limited settings.
CASE PRESENTATION: We report a preterm neonate born at 33 weeks of gestation with a birth weight of 1800 g who initially presented with respiratory distress and was managed as transient tachypnea of the newborn. The infant subsequently developed persistent fever, feeding intolerance, abdominal distension, leukopenia, severe thrombocytopenia, and elevated inflammatory markers despite initially negative blood cultures. A blood culture obtained on Day 20 of life grew multidrug-resistant S. Paratyphi A, resistant to ceftriaxone, ciprofloxacin, pefloxacin, and trimethoprim-sulfamethoxazole, with intermediate susceptibility to amikacin. The infant required blood-product support and prolonged antimicrobial therapy. A 21-day course of empiric cefoperazone/sulbactam plus levofloxacin was administered with close monitoring and was temporally associated with clinical improvement and microbiological clearance. Blood cultures obtained on Days 45 and 50 were negative. No maternal or apparent healthcare-associated source was identified.
CONCLUSION: Persistent multidrug-resistant S. Paratyphi A bacteremia should be considered in neonates with refractory sepsis despite initially negative blood cultures. Repeated cultures, reassessment of antimicrobial susceptibility, and cautious individualized treatment are essential when laboratory capacity and therapeutic options are limited. The effectiveness of empiric salvage therapy cannot be established without direct susceptibility data and stronger supporting evidence.
CASE PRESENTATION: We report a preterm neonate born at 33 weeks of gestation with a birth weight of 1800 g who initially presented with respiratory distress and was managed as transient tachypnea of the newborn. The infant subsequently developed persistent fever, feeding intolerance, abdominal distension, leukopenia, severe thrombocytopenia, and elevated inflammatory markers despite initially negative blood cultures. A blood culture obtained on Day 20 of life grew multidrug-resistant S. Paratyphi A, resistant to ceftriaxone, ciprofloxacin, pefloxacin, and trimethoprim-sulfamethoxazole, with intermediate susceptibility to amikacin. The infant required blood-product support and prolonged antimicrobial therapy. A 21-day course of empiric cefoperazone/sulbactam plus levofloxacin was administered with close monitoring and was temporally associated with clinical improvement and microbiological clearance. Blood cultures obtained on Days 45 and 50 were negative. No maternal or apparent healthcare-associated source was identified.
CONCLUSION: Persistent multidrug-resistant S. Paratyphi A bacteremia should be considered in neonates with refractory sepsis despite initially negative blood cultures. Repeated cultures, reassessment of antimicrobial susceptibility, and cautious individualized treatment are essential when laboratory capacity and therapeutic options are limited. The effectiveness of empiric salvage therapy cannot be established without direct susceptibility data and stronger supporting evidence.