关键词: 败血症, 李斯特菌, 婴儿, 新生

Abstract:
Objective
To study the clinical characteristics of Listeria infection in the newborn and to summarize the experience in diagnosis and treatment.
Methods
The clinical data of 11 children treated in the Children's Hospital of Zhengzhou University from December 2012 to December 2017 was analyzed, who were confirmed by blood culture to be with monocyte Listeria sepsis.
Results
(1) General data: there are 7 boys and 4 girls; 3 of them were delivered naturally and 8 by cesarean section; 5 were premature infants, whose mothers were all with high risk factors of one or more infection during perinatal period, and two mothers were also proved to have monocyte Listeria sepsis by blood culture; all the 11 children had their first onset within 7 days, and 5 within 48h. (2)Clinical manifestations: the main manifestations were fever(in 7 children), shortness of breath(5), groaning(5), cyanosis(7), skin rash(3) and secondary septic shock(5)(1 complicated with acute respiratory distress syndrome and 3 with disseminated intravascular coagulation). (3)Lab tests: the routine blood test showed that 8 children had increased WBC［(21.4～46)×109/L］, 2 were almost normal and one had decreased WBC(2.78×109/L);platelets were significantly lower in 3 children［(7～20)×109/L］;all had increased Creactive protein(>100 mg/L); 6 children were complicated with intracranial infection, and the blood culture showed it was Listeria monocytogenes, of whom the conventional blood culture was performed in the first 4 cases for 3 to 5 days, and for the other 7 with positive report; MALDITOF MS was used for 2 to 3 days; the culture of cerebrospinal fluid showed 4 positive cases, for treatment, ampicillin alone was used in one case, meropenem combined with vancomycin was used in 6 cases, and meropenem with ampicillin in 4 cases; for prognosis and followup: 9 children were cured with good growth and development, 1 asked to be discharged and was lost to follow up, and one was dead.
ConclusionListeria infection is a severe infectious disease in the early stage of a newborn and is commonly with an early onset. There are many complications and the mortality is high. The mothers of these neonates are often with high risk factors. Microbiological examination should be performed as early as possible to clarify the diagnosis. Attention should be paid to the possibility of Listeria infection when choosing the antibiotics in order to reduce the mortality and improve the prognosis.

Key words: Sepsis, Listeria, Infant,newborn