Neonatal septicemia caused by a rare pathogen: Raoultella planticola - a report of four cases

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Neonatal septicemia caused by a rare pathogen: Raoultella planticola - a report of four cases Xianrui Chen1,2,3, Shaoqing Guo1,2,3* , Dengli Liu1,2,3 and Meizhen Zhong1,2,3

Abstract Background: Raoultella planticola(R.planticola) is a very rare opportunistic pathogen and sometimes even associated with fatal infection in pediatric cases. Recently,the emergence of carbapenem resistance strains are constantly being reported and a growing source of concern for pediatricians. Case presentation: We reported 4 cases of neonatal septicemia caused by Raoultella planticola. Their gestational age was 211 to 269 days, and their birth weight was 1490 to 3000 g.The R. planticola infections were detected on the 9th to 27th day after hospitalization and occured between May and June. They clinically manifested as poor mental response, recurrent cyanosis, apnea, decreased heart rate and blood oxygen, recurrent jaundice, fever or nonelevation of body temperature. The C-reactive protein and procalcitonin were elevated at significantly in the initial phase of the infection,and they had leukocytosis or leukopenia. Prior to R.planticola infection,all of them recevied at least one broad-spectrum antibiotic for 727d.All the R.planticola strains detected were only sensitive to amikacin, but resistant to other groups of drugs: cephalosporins (such as cefazolin, ceftetan,etc) and penicillins (such as ampicillin-sulbactam,piperacillin, etc),and even developed resistance to carbapenem. All the infants were clinically cured and discharged with overall good prognosis. Conclusion: Neonatal septicemia caused by Raoultella planticola mostly occured in hot and humid summer, which lack specific clinical manifestations. Pediatricians should keep in mind that R. planticola can be a potential source of neonatal sepsis and even has the potential to acquire carbapenem-resistance. Preventing outbreaks of epidemics requires early detection, timely diagnosis and treatment, and active isolation. Keywords: Newborn;septicemia, Raoultella planticola, Nosocomial infections, Case report

* Correspondence: [email protected] 1 Department of Pediatrics, The First Affiliated Hospital of Xiamen University, No.55 Zhenhai Road, Xiamen 361003, China 2 Pediatric Key Laboratory of Xiamen, No.55 Zhenhai Road, Xiamen 361003, China Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitte

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