Oliveira Martins Marta, Marchante Pita Rita, Nogueira Mayara, Ferraz Ana, Martins João R
Pediatrics Department, Unidade Local de Saúde de Coimbra, Coimbra, PRT.
Neonatology Department, Maternidade Daniel de Matos, Unidade Local de Saúde de Coimbra, Coimbra, PRT.
Cureus. 2024 Nov 20;16(11):e74108. doi: 10.7759/cureus.74108. eCollection 2024 Nov.
Late-onset sepsis (LOS) is commonly associated with pathogens acquired in hospital or community settings and carries a significant risk of morbidity and mortality in neonates. We present a case of a late preterm neonate, born at 36 weeks and 2 days with low birth weight (1700 g), who was admitted to the neonatal intensive care unit (NICU) and developed LOS on the fourth day of life. LOS was diagnosed in the context of fever and lethargy, mild thrombocytopenia, leukopenia, and lymphopenia, and was caused by multidrug-resistant (MDR) , confirmed through blood culture. Initial empirical treatment with vancomycin and gentamicin was adjusted to gentamicin and meropenem based on the antibiogram, resulting in a swift and favorable clinical and laboratory response. This case, a rare occurrence in our NICU, provides an opportunity to discuss the etiology, risk factors, and clinical presentation of LOS related to as well as to highlight the growing concern of MDR microorganisms in the NICU setting.
晚发性败血症(LOS)通常与在医院或社区环境中获得的病原体有关,并且在新生儿中具有很高的发病和死亡风险。我们报告一例晚期早产儿病例,该婴儿出生时孕周为36周零2天,出生体重低(1700克),入住新生儿重症监护病房(NICU),并在出生后第四天发生LOS。LOS是在发热、嗜睡、轻度血小板减少、白细胞减少和淋巴细胞减少的情况下被诊断出来的,并且是由耐多药(MDR)病原体引起的,通过血培养得以证实。最初使用万古霉素和庆大霉素进行经验性治疗,根据抗菌谱调整为庆大霉素和美罗培南,从而带来了迅速且良好的临床和实验室反应。该病例在我们的NICU中较为罕见,为讨论与[此处原文缺失相关内容]相关的LOS的病因、危险因素和临床表现提供了机会,同时也凸显了NICU环境中对耐多药微生物日益增加的关注。