Serratia marcescens sepsis in neonates: clinical analysis of 21 cases / 中国新生儿科杂志

Objective To study the clinical characteristics of neonatal Serratia marcescens sepsis.Method A retrospective review of perinatal factors,clinical manifestations,laboratory findings,treatment and prognosis of Serratia marcescens sepsis in our unit from January 2012 to November 2017.Result A total of 21 cases of serratia marcescens sepsis were identified (diagnosed),all except one were prematurely born.Infection occurred on different days after birth,2 within 3 days,1 within 3 ～ 7 days and 9 in the second week,and the remainder,after 14 days.The clinical manifestations of neonatal Serratia marcescens sepsis were uncharacteristic,mainly manifested as gray pallor,lethargy,and recurrent apnea.Some infants had complications such as pulmonary hemorrhage,septic shock,necrotizing enterocolitis and scleroderma.Most infants had low white blood cell count,thrombocytopenia and high C-reactive protein at the onset of illness.All Serratia marcescens cases were sensitive to piperacillin/tazobactam,ceftazidime and meropenen.In total,17 cases had lumbar puncture,5 of them diagnosed with meningitis,with elevation of cerebrospinal fluid white blood cell count and protein,and 3 infants complicated with brain abscess.The duration of antibiotic therapy were 14 days or more depending on the clinical conditions.The overall mortality was 14.3％.Conclusion Serratia marcescens is an important opportunistic pathogen.It might cause serious infections in the premature infants including sepsis,brain abscess and meningitis.Regular neuro-imagings might be necessary for all sepsis infants.The infected and colonized neonates might be the hidden source of Serratia marcescens.The surveillance protocols,eradication of colonization,and strict adherence to hand disinfection/washing might help to prevent dissemination of invasive bacteria among premature infants.

Clinical analysis of 8 cases of neonatal septicemia caused by Candida haemulonii in neonatal intensive care unit / 中华儿科杂志

<p><b>OBJECTIVE</b>To study the clinical characteristics, antibiotics sensitivity, outcome and risk factors of neonatal septicemia caused by Candida haemulonii.</p><p><b>METHOD</b>A retrospective analysis was performed on clinical characteristics and antibiotics sensitivity after 8 cases of neonatal septicemia caused by Candida haemulonii were identified; each of these patients had at least one positive result of bacterial culture for Candida haemulonii.</p><p><b>RESULT</b>The 8 cases born at gestational age of 178-260 d, weighing 835-2 055 g, developed the infection from May to July at 10-34 d after hospitalization. Among the 8 patients, 7 were cured, 1 died during hospitalization after the treatments were given up because of serious complications. The 8 patients with septicemia caused by Candida haemulonii had similar clinical chariacteristics to those of other neonatal candidemia, such as apnea, fever, abdominal distension, jaundice etc. They had abnormal auxiliary examination with increased C-reactive protein (CRP), declined platelet (PLT) count to different degrees. All of the 8 patients had peripherally inserted central catheter (PICC) and broad-spectrum antibiotics were applied. C. haemulonii as an emergent fungal pathogen had varying degrees of resistance to fluconazole, amphotericin B, itraconazole, or ketone, but was susceptible to voriconazole.</p><p><b>CONCLUSION</b>The characteristics of neonatal septicemia caused by Candida haemulonii were similar to those caused by other candida, and the main risk factors are the low birth weight, PICC, and usage of broad-spectrum antibiotics. It mainly occurred in May to July which is hot and humid season.</p>

Percutaneous interventional techniques for the treatment of complications of AIDS / 中国介入影像与治疗学

Objective To observe clinical application value of percutaneous interventional techniques for the treatment of complications of AIDS.Methods Twenty-one AIDS patients with complications were enrolled.CT guided percutaneous needle biopsy and drainage were conducted,and the correct rate of diagnosis,clinical curative effect and complications post-interventional therapy were observed.Results The operations of all patients executed successfully.Fourteen patients underwent 16 times biopsy,11 were correctly diagnosed,the diagnostic accordance rate was 81.25%.Drainage was performed in 6 patients with abscess or cystis,then the lesions completely disappeared in 3,deflated in 2,while the rest one needed continously draining.Partial splenic embolization (50%) was performed in 1 patient,and after operation platelet content increased,while hepatic function decreased temporality.No complicated infection and other severe complications occurred.Conclusion Percutaneous interventional techniques for the treatment of complications of AIDS are safe and feasible.Medical staffs should be careful to exposition of HIV infection.