Sharma Deepak, Sharma Pradeep, Soni Priyanka, Gupta Basudev
NEOCLINIC, TN Mishra Marg, Everest Vihar, Nirman Nagar, Jaipur, Rajasthan, India.
Department of Medicine, Mahatma Gandhi Medical College, Jaipur, Rajasthan, India.
BMC Res Notes. 2017 Jan 7;10(1):28. doi: 10.1186/s13104-016-2347-1.
Ralstonia genus are gram negative bacillus and includes four bacteria namely Ralstonia picketti, Ralstonia Solanacearum, Ralstonia insidiosa and Ralstonia mannitolilytica. These are opportunistic pathogens and cause infections in immunocompromised host. The sources of infection are usually contaminated solutions and water. The majority of the reported cases are caused by R. picketti. It is very rare cause of neonatal sepsis with less than twenty cases reported in literature till date.
A late preterm male infant, Indian race was admitted to the neonatal intensive care unit for respiratory distress developing soon after birth. The infant was managed with respiratory support and gradually infant improved and diagnosis of transient tachypnea of newborn was made. At age of 84 h of postnatal life, the infant developed features of neonatal sepsis and investigations were suggestive of sepsis. The infant was started on intravenous antibiotic, multiple vasopressors and steroids. The blood culture showed growth of multi-drug resistant R. picketti. The antibiotics were changed as per sensitivity pattern and infant was discharged in good condition and was accepting breast feeding at the time of discharge. There was also no other case of R. picketti in the nursery during the same time period.
Ralstonia picketti is an uncommon cause of neonatal sepsis and usually source of infection are contaminated solutions and medical products. The management involves early detection, treatment with appropriate antibiotics and doing surveillance culture to identify the possible source of infection.
罗尔斯通氏菌属为革兰氏阴性杆菌，包括皮氏罗尔斯通氏菌、青枯雷尔氏菌、隐蔽罗尔斯通氏菌和曼氏罗尔斯通氏菌四种细菌。这些细菌为机会致病菌，可在免疫功能低下的宿主中引起感染。感染源通常为受污染的溶液和水。大多数报告病例由皮氏罗尔斯通氏菌引起。它是新生儿败血症的罕见病因，迄今为止文献报道的病例不到20例。
一名印度裔晚期早产儿男婴因出生后不久出现呼吸窘迫入住新生儿重症监护病房。该婴儿接受了呼吸支持治疗，病情逐渐好转，诊断为新生儿短暂性呼吸急促。出生后84小时，该婴儿出现新生儿败血症症状，检查提示败血症。该婴儿开始接受静脉抗生素、多种血管加压药和类固醇治疗。血培养显示多药耐药的皮氏罗尔斯通氏菌生长。根据药敏结果更换抗生素，婴儿出院时情况良好，出院时接受母乳喂养。同一时期，托儿所内也没有其他皮氏罗尔斯通氏菌感染病例。
皮氏罗尔斯通氏菌是新生儿败血症的罕见病因，感染源通常为受污染的溶液和医疗产品。治疗包括早期检测、使用适当抗生素治疗以及进行监测培养以确定可能的感染源。
