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Refractory Bacillus cereus infection in a neonate
R Tuladhar1, S K Patole, T H Koh
1Department of Neonatology, Kirwan Hospital for Women, Thuringowa, Queensland, Australia.
International Journal of Clinical Practice
|August 24, 2000
Summary
Bacillus cereus infections in neonates can be severe and resistant to treatment. This case highlights the challenges in managing these infections, even with aggressive therapy.
Area of Science:
- Neonatal Medicine
- Infectious Diseases
- Microbiology
Background:
- Bacillus cereus is a known cause of food poisoning.
- Its role as a pathogen in neonates has gained recognition.
- Neonates have compromised host defenses, increasing susceptibility.
Observation:
- A case of a preterm neonate (24 weeks gestation) with Bacillus cereus infection is presented.
- The infection was refractory to a 49-day course of multiple antibiotics and supportive therapies.
- Despite treatment, blood and bone marrow cultures remained persistently positive.
- No clear focus of sepsis was identified.
Findings:
- Bacillus cereus can cause severe, treatment-resistant infections in neonates.
- Environmental contamination is a likely source due to the organism's ubiquity.
- Combination therapy with vancomycin and gentamicin is suggested for severe Bacillus infections.
Implications:
- Emphasizes the significance of repeated Bacillus cereus isolation in neonates.
- Highlights the need for vigilance and potentially revised treatment strategies for neonatal Bacillus cereus infections.
- Underscores the challenges of managing infections in immunocompromised neonates.