Giacoia G P, West K
Department of Pediatrics, University of Oklahoma, Tulsa Medical College.
Am J Perinatol. 1989 Jan;6(1):49-54. doi: 10.1055/s-2007-999544.
Citrobacter diversus has been increasingly recognized as a cause of life-threatening neonatal meningitis with frequent abscess formation. This condition is associated with high mortality and extremely poor prognosis. We report our experience with C. diversus septicemia without meningitis in critically ill newborns. Thirteen patients with mean birthweight 1530 +/- 925 gm and mean gestational age 31.3 +/- 3.5 weeks were affected. They were compared with a group of infants affected by Escherichia coli sepsis, matched for weight, gestational age, and age at diagnosis. The groups did not differ in the incidence of perinatal complications, peripheral white blood cells, platelet count, and death rate. Hypotension was more frequently found in E. coli sepsis (p less than 0.05). All C. diversus isolates were resistant to gentamicin but sensitive to cephalosporins. C. diversus has become the most common nosocomial pathogen in our unit. Plasma profile analysis suggests that two different strains of C. diversus were involved in the outbreak reported here. Therapy for suspected C. diversus septicemia should include cephalosporins whenever resistance to aminoglycosides is demonstrated.
奇异柠檬酸杆菌越来越被认为是导致危及生命的新生儿脑膜炎并频繁形成脓肿的病因。这种情况与高死亡率和极差的预后相关。我们报告了我们在重症新生儿中治疗无脑膜炎的奇异柠檬酸杆菌败血症的经验。13例平均出生体重为1530 +/- 925克、平均胎龄为31.3 +/- 3.5周的患者受到影响。将他们与一组因大肠杆菌败血症而患病的婴儿进行比较，这些婴儿在体重、胎龄和诊断时的年龄方面相匹配。两组在围产期并发症的发生率、外周白细胞、血小板计数和死亡率方面没有差异。低血压在大肠杆菌败血症中更常见（p小于0.05）。所有奇异柠檬酸杆菌分离株对庆大霉素耐药，但对头孢菌素敏感。奇异柠檬酸杆菌已成为我们科室最常见的医院病原体。血浆谱分析表明，本文报告的暴发涉及两种不同菌株的奇异柠檬酸杆菌。一旦证明对氨基糖苷类耐药，对疑似奇异柠檬酸杆菌败血症的治疗应包括使用头孢菌素。
