期刊
INFECTIOUS DISEASES
卷 48, 期 6, 页码 461-466出版社
TAYLOR & FRANCIS LTD
DOI: 10.3109/23744235.2016.1144142
关键词
multi-drug resistance; meningoencephalitis; Escherichia coli; hypervirulence; neonate; meningitis
资金
- Department of Pediatrics, Vanderbilt University School of Medicine
- NIH [K08GM106143]
- CTSA award from National Center for Advancing Translational Sciences [UL1TR000445]
- [T32 HD068256]
Neonatal meningitis is a rare but devastating condition. Multi-drug resistant (MDR) bacteria represent a substantial global health risk. This study reports on an aggressive case of lethal neonatal meningitis due to a MDR Escherichia coli (serotype O75:H5:K1). Serotyping, MDR pattern and phylogenetic typing revealed that this strain is an emergent and highly virulent neonatal meningitis E. coli isolate. The isolate was resistant to both ampicillin and gentamicin; antibiotics currently used for empiric neonatal sepsis treatment. The strain was also positive for multiple virulence genes including K1 capsule, fimbrial adhesion fimH, siderophore receptors iroN, fyuA and iutA, secreted autotransporter toxin sat, membrane associated proteases ompA and ompT, type II polysaccharide synthesis genes (kpsMTII) and pathogenicity-associated island (PAI)-associated malX gene. The presence of highly-virulent MDR organisms isolated in neonates underscores the need to implement rapid drug resistance diagnostic methods and should prompt consideration of alternate empiric therapy in neonates with Gram negative meningitis.
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