1Department of Medical Microbiology, Manipal College of Medical Sciences, Pokhara, Nepal.
2Melaka Manipal Medical College, Manipal, India.
Antimicrob Resist Infect Control. 2019 Feb 8;8:29. doi: 10.1186/s13756-019-0490-x. eCollection 2019.
Vancomycin-resistant enterococcal infections in the neonatal ICU are growing global problems. We report a case of neonatal septicemia by multidrug-resistant vancomycin-resistant (VRE), the source of infection being the mother's gut.
A newborn male child admitted to the neonatal intensive care unit (NICU) was diagnosed to have mild meconium aspiration syndrome, early onset neonatal septicemia, and bacteremia by multidrug and vancomycin-resistant . Screening of gut flora of the baby and the mother were carried out to trace the source of infection. Stool cultures of the mother and the baby yielded Vancomycin-Resistant All three isolates of had similar antibiogram, harbored the A gene and similar pulsed-field gel electrophoresis pattern. Baby responded to the 1 week therapy with oral linezolid suspension 20 mg/kg/day, 1 ml/t.d.s. No VRE was isolated from baby on a repeat stool culture 1 week after the linezolid therapy. He was discharged with the advice for the continuance of linezolid for seven more days.
Isolation of MDR-VRE from the blood culture of the baby and stool specimens of the mother and the baby with the same antibiogram profile and clonal similarities reveals that maternal gut colonization was responsible for neonatal sepsis. Optimal infection control measures and the development of guidelines for monitoring VRE colonization in pregnant women might be useful in reducing the occurrence of neonatal sepsis.
耐万古霉素肠球菌感染在新生儿 ICU 中是一个日益严重的全球性问题。我们报告了一例新生儿败血症由多药耐药耐万古霉素肠球菌(VRE)引起,感染源是母亲的肠道。
一名男婴因新生儿重症监护病房(NICU)入院,被诊断为轻度胎粪吸入综合征、早发性新生儿败血症和耐多种药物和万古霉素的菌血症。对婴儿和母亲的肠道菌群进行了筛查,以追踪感染源。母亲和婴儿的粪便培养均检出耐万古霉素肠球菌。3 株耐万古霉素肠球菌的药敏谱相似,均携带 A 基因和相似的脉冲场凝胶电泳图谱。婴儿接受了 1 周的口服利奈唑胺混悬液 20mg/kg/天,1ml/t.d.s.治疗,1 周后粪便培养未见 VRE 生长。在利奈唑胺治疗后 1 周,婴儿再次进行粪便培养,未分离出耐万古霉素肠球菌,随后出院,并建议继续服用利奈唑胺 7 天。
从婴儿的血培养、母亲和婴儿的粪便标本中分离出 MDR-VRE,具有相同的药敏谱和克隆相似性,表明母亲肠道定植是导致新生儿败血症的原因。优化感染控制措施和制定监测孕妇 VRE 定植的指南可能有助于减少新生儿败血症的发生。