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The Journal of Pediatric Infectious Diseases and Immunology > Vol.32 No.3 contents > Abstract

Article in Japanese

Severe intrauterine Klebsiella pneumoniae infection in a preterm, very low birth weight infant of dichorionic diamniotic twins

Yuya SAITO1), Daisuke KOIKE1), Tomohiro HIRAIDE1), Fumihide KATO2), Akiyosi NARIAI1)

A male infant of dichorionic diamniotic twins was born at 29 gestational weeks by caesarean section due to labor pain. The mother had received ampicillin for preterm amniotic membrane rupture two weeks prior to the delivery. The infant presented with severe respiratory and circulatory failure immediately after birth. Following intensive treatment, such as antibiotics, intravenous immunoglobulin, steroids, nitric oxide and catecholamine, the infant became stable. Klebsiella pneumoniae was isolated from gastric fluid, nasal cavity, skin, pharynx, and stool culture, but not from blood cultures obtained at birth. In placental pathology, a chorioamnionitis was observed, and gram-negative rods were detected from the infant's side of the placenta. Therefore, the infant received a diagnosis of intrauterine K. pneumoniae infection.
As early-onset neonatal infections, caused by gram-negative bacteria, rapidly worsen immediately after birth, early intensive interventions are needed often. For the prevention of mother-to-infant microbial transmission, penicillin-resistant bacteria also must be considered.

1) Department of Pediatrics, Shimane Prefecture Central Hospital
2) Department of Neonatology, Shimane Prefecture Central Hospital

Key words Klebsiella pneumoniae, early-onset neonatal infection, gram-negative bacteria, mother-to-infant microbial transmission
Received December 19, 2019
Accepted June 23, 2020

32 (3):228─233,2020