Abstract
BackgroundProvidencia are gram negative motile rods and is a member of the Enterobacteriaceae family. It consists of five species, namely Providencia alcalifaciens, Providencia rustigianii, Providencia stuartii, Providencia rettgeri and Providencia heimbachae. These are opportunistic pathogens and leads to infections in immunocompromised host. Providencia rettgeri has been associated with the nosocomial infections of the urinary tract and infections of wounds, burns and blood. Providencia rettgeri is very rare cause of neonatal sepsis and we report first case of neonatal late onset sepsis secondary to it.Case presentationA term male infant presented on day 4 of post-natal life with the complaint of decreased appetite, fast respiration and lethargy. The clinical examination showed features of sepsis and shock with chest radiogram showing pneumonia. The infant was started on invasive ventilation, intravenous fluids, antibiotic and inotropes. The blood culture was suggestive of multi-drug resistant P. rettgeri. The antibiotics were changed according to organism antibiotic susceptibility pattern and infant gradually improved and was discharged successfully.ConclusionProvidencia rettgeri is a very rare organism to cause neonatal sepsis. The management involves early diagnosis, treatment with appropriate antibiotics and finding the source of infection.
Highlights
BackgroundThe bacteria of the genus Providencia have been included in the tribe Proteeae of family Enterobacteriaceae and consist of five species
Providencia are gram negative motile rods and is a member of the Enterobacteriaceae family
Providencia rettgeri was discovered by Rettger (1909) from a cholera like epidemic in chickens
Summary
The bacteria of the genus Providencia have been included in the tribe Proteeae of family Enterobacteriaceae and consist of five species. The clinical examination of the infant showed admission weight 2740 g, respiratory rate 72/min, heart rate 168 beats/min, capillary refill time of 4 s, audible grunting with subcostal and intercostal retraction, nasal flaring, mottling, abdominal distension, normal heart sounds and Downey’s score of 5/10. The infant was started on intravenous fluid and intravenous antibiotics (piperacillintazobactam and Amikacin). The blood culture sent from two different site using strict aseptic precaution with three swab techniques used before venipuncture, showed growth of P. The antibiotic sensitivity pattern of the organism showed sensitivity to Meropenem, Imipenem, Chloramphenicol, and Cotrimoxazole, resistance to Ampicillin, Amikacin, Amoxycillin-clavulanate, Ampicillin, Cefazolin, Cefepime, Cefotaxime, Ceftazidime, Cefixime, Ceftriaxone, Cefoperazone-sulbactam, Ciprofloxacin, Colistin, Ertapenem, Gentamicin, Levofloxacin, Ofloxacin, Piperacillin + Tazobactam, Piperacillin, Ticarcillin, and Tobramycin. The repeat blood culture sent after day 14 of intravenous Meropenem showed no growth. The infant was discharged in good condition and was accepting breast feeding at the time of discharge
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