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雷氏普罗威登斯菌新生儿败血症的首例病例报告。

First case report of Providencia Rettgeri neonatal sepsis.

作者信息

Sharma Deepak, Sharma Pradeep, Soni Priyanka

机构信息

DNB Neonatology, NEOCLINIC, TN Mishra Marg Everest Vihar Nirman Nagar, Jaipur, Rajasthan, India.

Department of Medicine, Mahatma Gandhi Medical College, Jaipur, Rajasthan, India.

出版信息

BMC Res Notes. 2017 Oct 30;10(1):536. doi: 10.1186/s13104-017-2866-4.

Abstract

BACKGROUND

Providencia are gram negative motile rods and is a member of the Enterobacteriaceae family. It consists of five species, namely Providencia alcalifaciens, Providencia rustigianii, Providencia stuartii, Providencia rettgeri and Providencia heimbachae. These are opportunistic pathogens and leads to infections in immunocompromised host. Providencia rettgeri has been associated with the nosocomial infections of the urinary tract and infections of wounds, burns and blood. Providencia rettgeri is very rare cause of neonatal sepsis and we report first case of neonatal late onset sepsis secondary to it.

CASE PRESENTATION

A term male infant presented on day 4 of post-natal life with the complaint of decreased appetite, fast respiration and lethargy. The clinical examination showed features of sepsis and shock with chest radiogram showing pneumonia. The infant was started on invasive ventilation, intravenous fluids, antibiotic and inotropes. The blood culture was suggestive of multi-drug resistant P. rettgeri. The antibiotics were changed according to organism antibiotic susceptibility pattern and infant gradually improved and was discharged successfully.

CONCLUSION

Providencia rettgeri is a very rare organism to cause neonatal sepsis. The management involves early diagnosis, treatment with appropriate antibiotics and finding the source of infection.

摘要

背景

普罗威登斯菌属是革兰氏阴性运动性杆菌,是肠杆菌科的成员。它由五个种组成,即产碱普罗威登斯菌、鲁氏普罗威登斯菌、斯氏普罗威登斯菌、雷氏普罗威登斯菌和海氏普罗威登斯菌。这些都是机会致病菌,可导致免疫功能低下宿主发生感染。雷氏普罗威登斯菌与医院获得性尿路感染以及伤口感染(烧伤和血液感染)有关。雷氏普罗威登斯菌是新生儿败血症非常罕见的病因,我们报告了首例继发于此菌的新生儿迟发性败血症病例。

病例报告

一名足月儿男婴在出生后第4天因食欲减退、呼吸急促和嗜睡就诊。临床检查显示败血症和休克体征,胸部X线片显示肺炎。该婴儿开始接受有创通气、静脉输液、抗生素和强心药治疗。血培养提示多重耐药雷氏普罗威登斯菌。根据细菌抗生素敏感性模式更换抗生素,婴儿逐渐好转并成功出院。

结论

雷氏普罗威登斯菌是引起新生儿败血症非常罕见的病原菌。治疗包括早期诊断、使用适当抗生素治疗并寻找感染源。

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