Department of Paediatrics, Division of Neurology, University of Calgary, Alberta Children's Hospital, Canada.
Acta Paediatr. 2012 Jan;101(1):e37-9. doi: 10.1111/j.1651-2227.2011.02431.x. Epub 2011 Aug 17.
Late-onset sepsis is a unique entity in the neonatal intensive care unit (NICU), as organisms involved are, by definition, nosocomial. As such, a limited number of microbes are characteristically involved. Leclercia adecarboxylata is a gram-negative bacillus rarely cultured in a clinical context, with the few published cases primarily involving immunocompromised adults. We present an ex-26-week newborn girl who developed late-onset sepsis with Leclercia adecarboxylata bacteraemia in the NICU. The infection was successfully treated with gentamicin and cefotaxime. This is the fifth paediatric report of Leclercia adecarboxylata infection, and the first in a neonate. The case raises the possibility that prior courses of antibiotics may have predisposed this individual to a rare infection essentially limited to immunocompromised individuals.
Leclercia adecarboxylata is a rare infection, particularly in immunocompetent individuals. In neonates, the clinical course can be good with timely initiation of appropriate antibiotics.
在新生儿重症监护病房（NICU）中，晚发性败血症是一种独特的病症，因为所涉及的病原体根据定义是医院获得性的。因此，通常只有少数几种微生物会涉及。阿克曼菌属是一种革兰氏阴性杆菌，在临床环境中很少培养，少数已发表的病例主要涉及免疫功能低下的成年人。我们报告了一例 26 周早产儿在 NICU 中发生晚发性败血症并伴有阿克曼菌属血行感染。该感染经庆大霉素和头孢噻肟治疗成功。这是第五例儿科阿克曼菌属感染病例，也是首例新生儿病例。该病例提示，先前使用抗生素可能使该个体易患这种基本上仅限于免疫功能低下个体的罕见感染。
阿克曼菌属感染较为罕见，特别是在免疫功能正常的个体中。在新生儿中，及时使用适当的抗生素治疗可能会有良好的临床转归。
