背景:Elizabethkingiameningoseptica是一种新兴的院内病原体,与新生儿败血症有关,具有高死亡率和发病率。然而,关于感染后的特征和结果的数据非常有限,特别是在发展中国家。
方法:我们进行了一项回顾性观察研究,研究对象是所有感染阳性的Elizabethkingia败血症的婴儿,研究他们的临床和流行病学特征,以及它们的抗菌敏感性模式,使用新生儿重症监护病房数据库中的结构化形式。使用描述性统计进行分析,并确定了死亡率和脑积水的预测因素。
结果:在21名新生儿中,9人(42.9%)为男性,平均胎龄和出生体重为31.7±3.4周和1320±364克,分别。发病年龄的中位数(四分位距)为7(5-12)天。总死亡率为23.8%,在幸存者中,50%有神经系统并发症需要干预。万古霉素和环丙沙星是我们系列中最常用的抗生素,中位持续时间为26(17-38)天。在单变量分析中,演示时的休克与死亡率增加显着相关(P=0.04),而,发病时癫痫发作(P=0.04)和脑脊液蛋白水平升高(P=0.01)预测存活新生儿的进行性脑积水。
结论:E.脑膜炎性败血症与高发病率和高死亡率相关。早期诊断和及时使用适当的抗生素对于改善生存率和神经发育结果至关重要。尽管通过环境监测来隔离生物体总是不可能的,采取适当的感染控制措施,感染是可以控制的。
BACKGROUND: Elizabethkingia meningoseptica is an emerging nosocomial pathogen implicated in neonatal sepsis with high mortality and morbidities. However, there is very limited data regarding the characteristics as well as outcomes following this infection, particularly in developing countries.
METHODS: We conducted a retrospective observational
study of all infants with culture-positive Elizabethkingia sepsis as part of an outbreak, to
study their clinical and epidemiological characteristics, as well as their antimicrobial susceptibility patterns, using a structured proforma from the neonatal intensive care unit database. Analysis was done using descriptive statistics and predictors of mortality and hydrocephalus were also identified.
RESULTS: Of the 21 neonates enrolled, 9 (42.9%) were male, with a mean gestational age and birth weight of 31.7 ± 3.4 weeks and 1320 ± 364 g, respectively. The median (interquartile range) age of onset of illness was 7 (5-12) days. The overall mortality rate was 23.8%, and among survivors, 50% had neurologic complications requiring intervention. Vancomycin and ciprofloxacin were the most used antibiotics for treatment in our series, with a median duration of 26 (17-38) days. On univariate analysis, shock at presentation was significantly associated with increased mortality (P = 0.04) while, seizures (P = 0.04) and elevated cerebrospinal fluid protein levels (P = 0 .01) at onset of illness predicted progressive hydrocephalus in surviving neonates.
CONCLUSIONS: E. meningoseptica sepsis is associated with high morbidity and mortality. Early diagnosis and prompt initiation of appropriate antibiotics are critical for improving survival and neurodevelopmental outcomes. Though isolation of the organism by environmental surveillance is always not possible, with proper infection control measures, the infection can be controlled.