PDF(Pubmed)
Abstract：
Pantoea agglomerans, a gram-negative bacterium, has emerged as an opportunistic pathogen, particularly within neonatal healthcare settings. Initially perceived as an innocuous environmental contaminant, P. agglomerans has been increasingly implicated in a spectrum of clinical infections, including neonatal sepsis and bacteremia. This systematic review conducts an in-depth analysis of the clinical cases published in 2003-2023, elucidating the multifaceted clinical presentations and therapeutic challenges associated with P. agglomerans infections in neonates. In total, 11 case reports and case series of 45 neonates from eight different countries were included. Most of the infected patients (57.8%) were reported in Asian countries (Sri Lanka, India, Kuwait) and involved preterm neonates (64.4%) with extremely low to low birth weight, and concurrent medical conditions including co-infections in a few of them (15.6%). Blood was the main culture source of the pathogen, accounting for 42 cases (91.1%) whereas clinical presentations in neonates exhibited considerable heterogeneity, encompassing common symptoms such as feeding difficulties, respiratory distress, fever, lethargy, and sepsis. Neonatal survival largely depended on the infection\'s origin and the timing of diagnosis. Considering antibiotic susceptibility as a criterion for treatment selection led to a 74% survival rate. Usually, a combination of antibiotics was used. There were 11 neonatal deaths reported, leading to an estimated mortality rate of 24.4%. We conclude that outbreaks within neonatal intensive care units underscore the importance of stringent infection control practices and heightened surveillance, especially considering the rapid disease progression noted in the included studies. Enhanced awareness and understanding of the clinical and microbiological characteristics of P. agglomerans infections are paramount for optimizing outcomes and reducing the burden of disease in neonatal populations.
摘要：
成团的泛菌,革兰氏阴性细菌,已经成为一种机会病原体，特别是在新生儿医疗机构中。最初被认为是无害的环境污染物，成团假单胞菌越来越多地参与一系列临床感染，包括新生儿败血症和菌血症。本系统综述对2003-2023年发表的临床病例进行了深入分析，阐明了与新生儿成群假单胞菌感染相关的多方面临床表现和治疗挑战。总的来说,包括来自八个不同国家的11例病例报告和45例新生儿病例系列。大多数感染患者（57.8％）在亚洲国家（斯里兰卡，印度,科威特），并涉及极低至低出生体重的早产儿（64.4％），以及并发的医疗状况，包括其中一些（15.6％）的合并感染。血液是病原体的主要培养源，占42例（91.1%），而新生儿的临床表现表现出相当大的异质性，包括常见的症状，如喂养困难，呼吸窘迫,发烧,嗜睡,还有败血症.新生儿的生存在很大程度上取决于感染的起源和诊断的时机。将抗生素敏感性作为治疗选择的标准导致74％的存活率。通常,使用了抗生素的组合。报告有11例新生儿死亡，导致估计死亡率为24.4%。我们得出的结论是，新生儿重症监护病房内的暴发强调了严格的感染控制措施和加强监测的重要性，特别是考虑到纳入的研究中提到的快速疾病进展。增强对聚集假单胞菌感染的临床和微生物学特征的认识和理解对于优化结果和减轻新生儿人群的疾病负担至关重要。
