Abstract
ABSTRACTExtremely low birth weight (ELBW) infants are at particularly high risk for infection due to an immature immune system, invasive procedures such as endotracheal intubation, intravascular catheterization, and other factors. Neonatal infections in this population are associated with a high mortality, poor growth, and neurodevelopmental outcomes. Pseudomonas aeruginosa (P. aeruginosa) infection is an uncommon but potentially devastating cause of pneumonia and sepsis in the ELBW population. P. aeruginosa is an important cause of healthcare-associated infections (HAI) or nosocomial infections. P. aeruginosa can perceive unfavorable environmental changes and orchestrate adaptations by developing plasmid-mediated and adaptive resistance to antibiotics. We describe an ELBW infant born at 26 weeks’ gestation who succumbed at 13 days of life to P. aeruginosa infection. Some of the factors related to the pathogenesis and multidrug resistance are described.
Highlights
Sepsis is a systemic inflammatory response syndrome in the presence of infection.[1]
Extremely low birth weight (ELBW) infants are at high risk for infection due to immature immune system, prolonged endotracheal intubation, presence of intravascular catheters, and other factors.[2,3]
P. aeruginosa is an important cause of healthcare-associated infections (HAI).[6]
Summary
Sepsis is a systemic inflammatory response syndrome in the presence of infection.[1]. In the U.S, bacterial sepsis is a leading cause of neonatal mortality, affecting 32,000 live births annually.[1] ELBW infants are at high risk for infection due to immature immune system, prolonged endotracheal intubation, presence of intravascular catheters, and other factors.[2,3] Neonatal infections in this population are associated with a high mortality, poor growth, and neurodevelopmental outcomes.[1,2,3] P. aeruginosa infection is an uncommon but potentially devastating cause of pneumonia and sepsis in the extreme preterm population This gram-negative, encapsulated, aerobic, rod-shaped bacterium belongs to the family of Pseudomonadaceae, which is in the class of gammaproteobacteria.[4,5] It is recognized for being an opportunist pathogen, usually infecting an immunocompromised host.[4,5] generally, it is aerobic, it is a facultative anaerobe, as it is well adapted to proliferate in conditions of partial or total oxygen depletion.[4,5] P. aeruginosa is an important cause of healthcare-associated infections (HAI).[6] An estimated 5-15% of all hospitalized patients experience an HAI, and the emergence of multi-drug resistance (MDR) has added to the devastating effects of P. aeruginosa. In a study of 41.6 million hospitalized patients in a cohort of 890 U.S hospitals, the incidence for MDR P. aeruginosa infection has only marginally decreased from 13.1 to 9.4 per 10,000 hospitalizations from 2012 to 2017.8 we describe a patient with late-onset sepsis due to P. aeruginosa
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