Clinical features and drug resistance of Listeria monocytogenes infection in neonates / 中华实用儿科临床杂志

ABSTRACT

Objective To study the clinical distribution of Listeria monocytogenes infection and the changes in drug resistance of Listeria monocytogenes isolated from inpatients during recent 3 years,and to increase the awareness of the situation and provide data for clinical antibiotics application.Methods The clinical distribution of 22 cases of neonatal Listeria infection and drug resistance changes of Listeria were retrospectively analyzed in Bayi Children's Hospital from Jan.2011 to Dec.2013.Results Neonates began to be attacked by Listeria monocytogenes of 0.5 hours to 5 days (an average of 17.45 hours) after birth.The average birth weight was (2 331.82 ± 677.64) g.There were 7 full term cases and 15 premature infants,13 cases with low birth wcight.The average hospitalization was (21.91 ± 17.64)days.The cure rate was 45.45％ (10/22 cases).All the mothers of 15 cases had fever in the third trimester of pregnancy and the temperature was 37.5-39.5 ℃.Infection rate with Listeria monocytogenes in neonatal was 0.03％ (2/7 137 cases),0.11％ (8/7 281 cases) and 0.19％ (12/6 394 cases) in 3 years,respectively.From 2011 to 2013,the sensitive rate of antimicrobial drugs with Listeria monocytogencs to commonly used antimicrobial was 82.72％,75.40％ and 50.66％,and the rate of drug resistance was 17.28％,17.50％ and 11.01％,respectively.During 3 years,the rates of drug resistance had no significant difference (x2 =3.65,P ＞ 0.05),and the sensitive rates had a trend of declination year by year(x2 =36.87,P ＜ 0.01).The sensitive rates and the drugs resistant rates of penicillin were 33.93％ (19/56 cases)and 51.79％ (29/56 cases),respectively.In 3 years,the drugs resistant rates of penicillin was 100.00％,40.00％,and 46.43％,and the sensitive rate was 0,60.00％,25.00％,respectively.There was a high sensitivity of Listeria monocytogenes to ampicillin,aminoglycoside,sugar peptide,tetracycline,macrolides,lincosamides,quinolone,sulfa and other classes (such as rifampicin).It showed the different drug resistance rates with 33.33％-100.00％ to oxacillin,penicillin G and nitrofurans.Conclusions These children has the characteristics of early-onset infection.The pregnant women and newborns are susceptible to high-risk groups.Infection rates with Listeria of neonatal and Listeria monocytogenes isolated from inpatients showed a trend of increase year by year.The cases were very sensitive to commonly used antimicrobial for killing Listeria monocytogenes.There was a trend of the declination for drug resistance to penicillin,but it was still at a higher level.The drugs resistance rate to oxacillin,penicillin G and nitrofurans were high.