OBJECTIVE To investigate the clinical characteristics and current status of diagnosis and treatment of the neonates with Listeria monocytogenes sepsis and analyze the drug resistance of the L. monocytogenes strains.
METHODS The clinical data were collected from the neonates with LM sepsis who were treated in neonatology departments of 23 collaborative hospitals of Hebei Neonatal Sepsis Research Group from Nov. 1, 2021 to Dec. 31, 2022. The whole genome sequencing was performed for the strains isolated from blood culture, and the drug resistance genes of the strains were observed.
RESULTS A total of 11 neonates with LM sepsis who were treated in the 7 hospitals were enrolled in the study, all were of early-onset types, and nine were premature infants. The placenta pathological examination was carried out for eight neonates, and six neonates were diagnosed with chorioamnionitis. All of the neonates needed respiratory support, and ten neonates needed endotracheal intubation for mechanical ventilation. Four neonates were complicated by ventricular hemorrhage and/or intraparenchymal hemorrhage, three were complicated by purulent meningitis, two were complicated by septic shock, and one was complicated by disseminated intravascular coagulation. Meropenem was the most commonly used antibiotic in the study, nine neonates were treated with single meropenem or combination with other antibiotics. Three of the 11 neonates died. 4 strains of LM that were isolated from blood culture did not carry penicillin resistance genes.
CONCLUSIONS The LM sepsis usually occurs in the neonates within 3 days after the birth. Maternal chorioamnionitis and premature delivery are the major perinatal characteristics. The respiratory support is usually necessary for the neonates, the mortality rate and incidence of complications are high. The detection of drug resistance genes may facilitate the reasonable use of antibiotics.
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