Zhang Shasha, Li Jinchun, Wan Li, Yu Jing, Chen Sumei, Jin Zhengjiang
Department of Pharmacy, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430070, People's Republic of China.
Department of Neonatology, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430070, People's Republic of China.
Infect Drug Resist. 2023 Oct 11;16:6647-6659. doi: 10.2147/IDR.S431402. eCollection 2023.
To determine the clinical features, laboratory findings, antibiotic treatment, and outcomes of neonatal listeriosis in a specialized tertiary hospital in Wuhan, China.
We retrospectively analyzed the medical records of patients diagnosed with neonatal listeriosis at Maternal and Child Health Hospital of Hubei Province from January 2015 to December 2022. Listeriosis was indicated by positive culture for Listeria monocytogenes (LM).
A total of 11 cases were included in our study. The incidence rate of neonatal listeriosis was 2.06 per 100,000 live births. Seventy-three percent of the cases were born prematurely, caused early onset sepsis. Respiratory distress (100%) was the most common and earliest symptom, followed by fever (64%) and rashes (27%). The levels of C-reactive protein (CRP) and procalcitonin (PCT) were elevated in 100% of the cases. The median time-to-positivity (TTP) of the culture was 15 hours (range 9-28hours). Of the 11 neonates, 6 were cured, 2 showed improvement, and 3 died, with a mortality rate of 27%. There were statistically significant differences in Apgar score at 5 minutes (p=0.037) and CRP (p=0.025) between the survival group and fatality group. Ampicillin was sensitive to LM isolates and effective for therapy if initiated early.
Neonatal listeriosis is a rare but severe infection with a high mortality rate. Early identification and appropriate use of effective antibiotics are particularly critical for achieving positive outcomes. Apgar score and CRP are relevant indices for prognosis. Ampicillin is the first-line therapy and can be empirically administered to neonates suspected of having listeriosis.
确定中国武汉一家专业三级医院新生儿李斯特菌病的临床特征、实验室检查结果、抗生素治疗及预后情况。
我们回顾性分析了湖北省妇幼保健院2015年1月至2022年12月期间诊断为新生儿李斯特菌病的患者病历。单核细胞增生李斯特菌（LM）培养阳性表明患有李斯特菌病。
我们的研究共纳入11例病例。新生儿李斯特菌病的发病率为每10万例活产儿2.06例。73%的病例为早产儿，引发早发型败血症。呼吸窘迫（100%）是最常见和最早出现的症状，其次是发热（64%）和皮疹（27%）。100%的病例C反应蛋白（CRP）和降钙素原（PCT）水平升高。培养的中位阳性时间（TTP）为15小时（范围9 - 28小时）。11例新生儿中，6例治愈，2例好转，3例死亡，死亡率为27%。存活组和死亡组在5分钟时的阿氏评分（p = 0.037）和CRP（p = 0.025）存在统计学显著差异。氨苄西林对LM分离株敏感，若早期使用对治疗有效。
新生儿李斯特菌病是一种罕见但严重的感染，死亡率高。早期识别和合理使用有效抗生素对取得良好预后尤为关键。阿氏评分和CRP是预后的相关指标。氨苄西林是一线治疗药物，可凭经验用于疑似患有李斯特菌病的新生儿。
