Department of Neonatology, Dr. Sami Ulus Maternity and Children's Health and Diseases Training and Research Hospital, Ankara, Turkey.
Eur J Pediatr. 2012 Oct;171(10):1503-9. doi: 10.1007/s00431-012-1756-y. Epub 2012 May 31.
Burkholderia gladioli is a rare cause of bacteremia and sepsis in the absence of such predisposing factors as chronic granulomatous disease, cystic fibrosis, and immunosuppression. Little is known about B. gladioli infection in newborns. The aim of this study was to present the features of B. gladioli infection in newborns. Clinicopathological characteristics, patterns of antimicrobial susceptibility, predisposing factors, and outcomes of B. gladioli bloodstream infection were retrospectively analyzed in newborns treated between 2008 and 2011. During the 3-year study period, B. gladioli was isolated from the blood cultures of 14 patients (3.7 per 1,000 admissions). In all, 5 (35.7 %) of the 14 cases had a positive blood culture at the time of initial admission. Primary diagnoses in the neonates were severe major congenital anomalies, congenital leukemia, prematurity with respiratory distress syndrome, pneumonia, and parapneumonic pleural effusion. In total, 10 (71.4 %) of the patients underwent ≥2 invasive procedures. The overall in-hospital mortality rate was 21.4 %, whereas the mortality rate due to B. gladioli infection was 7 %.
B. gladioli might be a causative microorganism of both early neonatal and nosocomial sepsis in newborns. To the best of our knowledge, this is the first study on B. gladioli infection in newborns. Invasive procedures and severe major congenital anomalies may be predisposing factors for B. gladioli bloodstream infection in neonates. Although it appears to have low pathogenic potential and an insidious clinical course in newborns, resistance to antibiotics may be a potential problem. Mortality was primarily associated with underlying diseases.
介绍新生儿中博氏疏螺旋体感染的特点。
回顾性分析 2008 年至 2011 年间收治的 14 例博氏疏螺旋体血流感染新生儿的临床病理特征、抗菌药物敏感性模式、易感因素和结局。
在 3 年的研究期间，博氏疏螺旋体从 14 例患者（每 1000 例入院患者 3.7 例）的血培养中分离出来。所有患者中，5 例（35.7%）在初次入院时血培养阳性。新生儿的主要诊断为严重的主要先天性异常、先天性白血病、伴呼吸窘迫综合征的早产儿、肺炎和肺炎旁胸腔积液。共有 10 例（71.4%）患者进行了≥2 次侵入性操作。总的院内死亡率为 21.4%，而博氏疏螺旋体感染的死亡率为 7%。
博氏疏螺旋体可能是新生儿早期和医院获得性败血症的致病微生物。据我们所知，这是首例关于新生儿博氏疏螺旋体感染的研究。侵入性操作和严重的主要先天性异常可能是新生儿博氏疏螺旋体血流感染的易感因素。尽管博氏疏螺旋体在新生儿中似乎具有较低的致病潜力和隐匿的临床病程，但对抗生素的耐药性可能是一个潜在的问题。死亡率主要与基础疾病有关。
