Pawlik Dorota, Lisowska-Miszczyk Ilona, Radziszewska Renata, Ochoda Agnieszka, Drzewiecki Artur, Podsiadło Lilianna, Pawlik Wiesław, Heczko Piotr, Lauterbach Ryszard
Klinika Neonatologii UJ CM, ul. Kopernika 23, 31-501 Kraków.
Med Wieku Rozwoj. 2009 Jan-Mar;13(1):40-4.
Bacillus cereus is an aerobic or facultative anaerobic Gram-positive rod which is ubiquitous in the environment. The incidence of neonatal infections is very low. The clinical course is serious, usually life- threatening or permanently damaging the central nervous system. The immature immune system, subjected to invasive procedures, increases the morbidity risk in this age group, especially in extremely low birth weight infants. Diagnostic difficulties and insusceptibility to ''first- line'' antibiotics can delay effective therapy and increase the risk of its failure. We report a 730 g preterm neonate, delivered at 27 weeks gestation with late- onset sepsis due to Bacillus cereus. The disease course was complicated by development of brain abscesses. We describe the clinical course of infection, diagnostic difficulties and the treatment. After the 140 days of hospitalization and relatively long period of therapy with different antibiotics, the patient was discharged from hospital in good condition. Despite of transmission of infection to the central nervous system, the introduced therapy prevented severe neurological disabilities as confirmed during the evaluation according to the Bayley Scale of Infant Development, performed at 29 months of life.
蜡样芽孢杆菌是一种需氧或兼性厌氧的革兰氏阳性杆菌，在环境中广泛存在。新生儿感染的发生率很低。临床病程严重，通常危及生命或永久性损害中枢神经系统。未成熟的免疫系统因接受侵入性操作而增加了该年龄组的发病风险，尤其是极低出生体重儿。诊断困难以及对“一线”抗生素不敏感会延迟有效治疗并增加治疗失败的风险。我们报告一例730克的早产儿，孕27周出生，患有由蜡样芽孢杆菌引起的晚发性败血症。病程因脑脓肿的形成而复杂化。我们描述了感染的临床过程、诊断困难及治疗情况。经过140天的住院治疗及使用不同抗生素的较长疗程治疗后，患者康复出院。尽管感染已传播至中枢神经系统，但根据婴儿发育贝利量表在患儿29个月时进行评估证实，所采用的治疗预防了严重的神经功能障碍。
