Pantoea agglomerans bloodstream infection in preterm neonates.

OBJECTIVE

To report an uncommon incidence of sporadic bloodstream infection (BSI) caused by Pantoea agglomerans in preterm neonates.

CASE PRESENTATION AND INTERVENTION

Fives cases of nosocomial BSI with P. agglomerans in preterm neonates (weight <or=1,500 g; age 8-17 days; gestational age 26-30 weeks) are presented. All cases were late onset neonatal sepsis (>7 days of age). Lethargy, skin mottling and bradycardia were often present. Although there was no evidence of pneumonia, desaturation was a common feature. Thrombocytopenia developed in 4 patients, metabolic acidosis in 2 and jaundice in 2. No bleeding tendency or disseminating intravascular coagulation was recorded. Organisms cultured from blood were identified by the Vitek-2 system (bioMérieux, France) and the findings confirmed by testing the isolate on the API 20E system. All isolates shared in vitro susceptibility to gentamicin, amikacin, ciprofloxacin, piperacillin/tazobactam and meropenem. One patient was treated with a cefotaxime/amikacin combination, 2 with meropenem and the remaining 2 with tazocin. All patients responded well to antibiotic treatment and survived.

CONCLUSION

P. agglomerans is an unusual pathogen in the etiology of neonatal sepsis. Despite significant clinical deterioration, early detection and proper antibiotic therapy carry a favorable outcome.