Effect of PMX-DHP for sepsis due to ESBL-producing E. coli in an extremely low-birthweight infant

Area of Science:

• Neonatal Medicine
• Infectious Diseases
• Pharmacology

Background:

• Early-onset sepsis in preterm infants poses significant mortality risks.
• Extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae infections present treatment challenges due to antibiotic resistance.
• Extremely low-birthweight infants are particularly vulnerable to severe infections.

Observation:

• A case of early-onset sepsis in a preterm infant (601g) caused by ESBL-producing Escherichia coli (CTX-M type) is presented.
• The infant received meropenem for antibiotic treatment.
• Polymyxin B-immobilized fiber treatment was administered for endotoxin absorption with a minimal priming volume (8 mL).

Findings:

• The patient survived the severe sepsis without short-term neurological or respiratory complications.
• Successful management highlights the importance of appropriate antibiotic selection for ESBL infections in neonates.
• Polymyxin B hemoperfusion demonstrated potential efficacy in managing severe neonatal sepsis.

Implications:

• This case suggests polymyxin B hemoperfusion may be an innovative therapeutic option for severe neonatal sepsis.
• The treatment approach could improve outcomes in extremely low-birthweight infants with multidrug-resistant organism infections.
• Further research into polymyxin B hemoperfusion for neonatal sepsis is warranted.