Nosocomial Klebsiella variicola Infection in Neonatal Intensive Care: A New Emerging Pathogen

Klebsiella variicola is a human pathogen that has been misidentified as K. pneumoniae. This misidentification has led to a lack of understanding of important clinical and biological aspects of this bacterial species. It is responsible for serious and potentially fatal infections, with a prevalence of multi-resistance to routine antibiotics. We present through three clinical observations, the case of three newborns having been hospitalized in the neonatal intensive care unit and whose evolution was complicated by the occurrence of a nosocomial infection in front of which a blood culture was done on blood agar, with a manual antibiogram on antibiotic disks, isolated the germ Klebsiella variicola. The management of the newborns was initially centered on non-invasive ventilation with a bi-antibiotic therapy based on carbapenem and amikacin for two newborns and switched to colymicin for the third case. Newborn follow-up was based on assessment of general condition, clinical signs of infection, as well as a biological control made of a blood count, a c-reactive protein, a complete ionogram, and a blood culture, every four days or if signs of clinical call. The evolution was favorable for two cases with good clinical and biological improvement, and complicated by death due to alveolar hemorrhage in the third case. Given the high pathogenicity of this germ, and the frequency of misidentification, it is crucial to know the clinical spectrum of Klebsiella variicola infections in neonatal intensive care units, in order to adapt the antibiotic therapy and to mitigate the fulminant evolution of this germ.

Epidemic to Different Strains of SERRATIA: Experience of Neonatal Intensive Care Unit: About 30 Cases

Serratia is an opportunistic pathogenic bacterium of the Enterobacteriaceae family, occasionally responsible for epidemics of nosocomial infections in critical departments;in particular in neonatal intensive care units Enterobacteriaceae form a large family of Gram-negative bacteria, which cause diseases of highly variable severity, due to distinct pathogenic mechanisms. This family is heterogeneous as it consists of about 30 genera of bacteria and more than 100 species. However, all these germs have in common their preferential location in the digestive system, some being part of the normal flora although they are also present in the environment. Several metabolic processes characterize this bacterial family. These include the ability to reduce nitrate to nitrite (for energy generation), ferment glucose, lack cytochrome oxidase, be aerobic or anaerobic, motile or immobile, … Enterobacteriaceae constitute more than 80% of the germs isolated in the laboratory: Escherichia, Salmonella, Shigella, Klebsiella, Enterobacter, Serratia, Proteus, Morganella and Yersinia are the rods most often found. Regarding nosocomial infection to Serratia, this bacterium colonizes the respiratory, digestive and urinary systems of patients, mainly responsible for bacteremia, infections of the lower respiratory tract, urinary and skin infections. Through our work, we report the epidemic experienced in the neonatal intensive care unit MOHAMMED VI university hospital, mother-child hospital MARRAKECH MOROCCO for three months from December at February 2023 interesting 30 newborns whose clinical presentation was different, the positive diagnosis was based on blood and geographical samples taken by the bacteriology department to isolate the offending germs, the therapeutic management of our patients consisted essentially of various hygiene measures in association with dual antibiotic therapy based on meropenem and amikacin. The evolution was marked by the death of 21 patients (70%) and the recovery of 9 patients (30%). The prognosis of infection by serratia remains bleak with high morbidity interest in prevention by respecting the rules of hygiene, which begins with hand disinfection.

Neonatal Pleuropulmonary Staphylococcal Disease: A Case Report

Staphylococcal pleuropulmonary disease (SPP) is the localization of pathogenic staphylococcal disease in the lung and pleura and its general haematogenic consequences. This location is not primary, but follows a primary skin or mucous infection that may go unnoticed. This is a very rare phenomenon in neonatology and in the various literature reviews. Through our observation we report the clinical diagnosis of a newborn 13-day age with pleuro-pulmonary staphyloccocia point of departure cutaneous, thus the paraclinical explorations performed in our patient therapeutic management and evolutionary profile after a 3-month decline. Note that the problem of resistance of staphylococci to different antibiotics is currently a real public health problem making the choice of treatment very difficult for the clinician.

Pantoea SPP: A New Nosocomial Infection in the Neonatal Intensive Care Unit

Pantoea SPP is a gram-negative bacillus, which usually colonizes plants, soil and water. This pathogen very rarely causes neonatal sepsis. The most common infections caused by Pantoea SPP are septic arthritis or synovitis, meningitis frequently complicated by brain abscess, upper respiratory infections, and peritonitis. We present the case of a premature infant who presented neonatal respiratory distress and whose evolution was complicated by the occurrence of a nosocomial infection for which a blood culture was performed isolating the germ Pantoea SPP. The patient’s management was initially centered on non-invasive ventilation with antibiotherapy based on carbapenem and aminoglycoside. Due to the clinical and biological worsening, the neonate was intubated and sedated and put on colymicin. The evolution was unfavorable marked by a death at 16th days of life. Considering the high pathogenicity of this germ and its multi-resistance to antibiotics, it is crucial to know the clinical spectrum of Panteoa SPP infections in neonatal intensive care units, in order to palliate the fulminant evolution of multifocal attacks due to this germ.

Pediatric Inflammatory Multisystem Syndrome;Unusual Presentation of COVID-19 in Children: About Thirty Cases

Pediatric inflammatory multisystem syndrome PIMS is a new entity of systemic inflammatory disease in children that appeared in the epidemic context of COVID-19 infection in April 2020. The pathophysiological mechanisms of PIMS are poorly understood and the hypothesis of a maladaptive hyperactive immune response, notably involving cytokines, is described in the literature. In our study, we report our experience regarding the clinical presentation, diagnosis, management and outcome of patients who presented with pediatric inflammatory multisystem syndrome post COVID-19.

COVID-19 and Pregnancy—Series of Cases and Review of Literature

Objectives: To bring out the clinical, biological, and therapeutic aspects of pregnant women and women in the post-partum infected by the SARS COVID-19 in the University hospital of Marrakesh. To study the vertical transmission of the virus if it exists, and the impact on the newborn. Methods: It is a prospective observational study on women infected by COVID-19 virus admitted in the gynecology obstetrics department of the University hospital of Marrakesh during the period between March 1st and July 15th. Data collection was insured thanks to a customized form containing the medical history, clinical criteria, biological and, radiological findings as well as the treatment and maternal and neo-natal outcomes. Results: The clinical, biological and radiological presentation of COVID-19 infection in pregnant and post-partum women doesn’t seem to be different from general population. Pregnant and post-partum women don’t seem to be more at risk to develop severe features of the disease. Vertical transmission via placenta is possible. COVID-19 infection may cause premature labor, premature rupture of membranes, preeclampsia or fetal distress.