Intrinsically Resistant Bacteria as Looming Disaster: A Rare Case Report of Elizabethkingia meningoseptica Meningitis in a Neonate.
Intrinsically Resistant Bacteria as Looming Disaster: A Rare Case Report of Elizabethkingia meningoseptica Meningitis in a Neonate.
复制标题
耐药性细菌作为迫在眉睫的灾难：一个罕见的病例报告，脑膜炎败血症的脑膜炎新生儿。
DOI：
10.1055/s-0041-1724234
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发表时间：
2021-03
影响因子：
1.1
通讯作者：
Padhi P
中科院分区：
文献类型：
--
作者：
Patro P;Das P;Padhi P
脑膜炎败血症是新生儿脑膜炎的公认原因，死亡率约为57%，但印度详细描述这些感染的临床数据仍然有限。虽然该细菌具有革兰氏阴性特征，但它通常对通常用于革兰氏阴性细菌感染的抗生素具有多重耐药性，并且对革兰氏阳性细菌的抗生素敏感，因此对治疗临床医生构成严重挑战。这种新生儿脑膜炎病例最常见于出生体重< 2,500 g的早产儿，但在此我们报告一例罕见的新生儿脑膜炎病例，该病例是由这种罕见的病原体引起的，其体重与胎龄相当。该分离株是多药耐药和差异之间的光盘扩散和自动抗生素敏感性测试的几种抗生素。由于及时鉴定了致病微生物并及早开始适当的抗菌治疗，该病例通过哌拉西林-他唑巴坦、万古霉素、氯霉素和利福平联合治疗成功管理，共持续28天。E.脑膜炎败血症可引起严重感染，新生儿有高死亡率和神经系统后遗症的风险。重症监护和多学科干预对病例管理至关重要。
Elizabethkingia meningoseptica is a recognized cause of neonatal meningitis with high mortality rate of approximately 57%, but clinical data detailing these infections remain limited from India. Though this bacteria has a Gram-negative character, it is usually multidrug resistant to antibiotics usually prescribed for Gram-negative bacterial infections and susceptible to antibiotics for Gram-positive bacteria, thus poses a serious challenge to the treating clinicians. Such cases of neonatal meningitis is most commonly associated with prematurity with birth weight < 2,500 g, but here we report an uncommon case of neonatal meningitis due to this rare pathogen in a full-term neonate with weight as per gestational age. The isolate was multidrug resistant and discrepancy was seen between disc diffusion and automated antibiotic susceptibility testing for few antibiotics. The case was successfully managed by treatment with combination of piperacillin-tazobactam, vancomycin, chloramphenicol, and rifampicin for a total duration of 28 days, due to prompt identification of the causative organism and initiation of appropriate antimicrobial therapy early. E. meningoseptica can cause severe infection, with risk of high mortality and neurological sequelae in neonates. Intensive care and multidisciplinary interventions are crucial for case management.