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嗜麦芽寡养单胞菌新生儿败血症:1 例报告。

Stenotrophomonas maltophilia neonatal sepsis: a case report.

机构信息

Medical Research Council Unit The Gambia at London, School of Hygiene and Tropical Medicine, West Africa, PO Box 273, Fajara, The Gambia.

Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK.

出版信息

J Med Case Rep. 2024 Mar 25;18(1):180. doi: 10.1186/s13256-024-04479-2.

Abstract

BACKGROUND

Stenotrophomonas maltophilia is a gram-negative bacteria known for causing opportunistic and nosocomial infections in humans. S. maltophilia is an emerging pathogen of concern due to it's increasing prevalence, diverse disease spectrum, intrinsic multi-drug resistance and high mortality rates in immunocompromised individuals. S. maltophilia is a rare cause of neonatal sepsis associated with significant morbidity and mortality. The bacterium's multi-drug resistance poses a considerable challenge for treatment, with various mechanisms contributing to its resistance.

CASE PRESENTATION

We report a case involving a 40-h-old male African neonate who exhibited symptoms of neonatal sepsis. The blood culture revealed Stenotrophomonas maltophilia, which was sensitive to ciprofloxacin and gentamicin but resistant to other antibiotics. Lumbar puncture for CSF could not be done because the father declined. We treated the newborn with the empirical first-line antibiotics as per the national guideline intravenous ampicillin and gentamicin for six days, and the child recovered fully with a repeated negative blood culture.

CONCLUSIONS

This report describes a neonatal sepsis case caused by S. maltophilia, a multi-drug resistant bacteria and a rare cause of neonatal sepsis. We report that early detection of the bacterial and antimicrobial management based on local antibiogram data may be essential for successful patient's management.

摘要

背景

嗜麦芽窄食单胞菌是一种革兰氏阴性细菌,已知会导致人类机会性和医院获得性感染。由于其日益增加的流行率、多样化的疾病谱、内在的多药耐药性以及免疫功能低下个体的高死亡率,嗜麦芽窄食单胞菌已成为一种令人关注的新兴病原体。嗜麦芽窄食单胞菌是一种罕见的新生儿败血症病因,与较高的发病率和死亡率相关。该细菌的多药耐药性对治疗构成了相当大的挑战,其耐药机制多种多样。

病例介绍

我们报告了一例 40 小时大的非洲男婴,出现新生儿败血症的症状。血培养显示嗜麦芽窄食单胞菌对环丙沙星和庆大霉素敏感,但对其他抗生素耐药。由于父亲拒绝,未能进行腰椎穿刺以获取脑脊液。根据国家指南,我们对新生儿进行经验性一线抗生素治疗,静脉注射氨苄西林和庆大霉素六天,重复血培养阴性后患儿完全康复。

结论

本报告描述了一例由嗜麦芽窄食单胞菌引起的新生儿败血症病例,嗜麦芽窄食单胞菌是一种多药耐药菌,也是新生儿败血症的罕见病因。我们报告称,早期检测细菌并根据当地药敏数据进行抗菌药物管理可能对成功治疗患者至关重要。

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