关键词: 李斯特菌病；　败血症；　治疗；　新生儿

Abstract: Objective　To explore the clinical characteristics, treatment with antibiotics and prognosis of neonatal listeriosis. Method　The clinical data of 9 patients with early-onset neonatal listeriosis diagnosed by blood culture from January 2010 to March 2018 were retrospectively analyzed. Results　In 9 patients(6 boys and 3 girls), 7 were premature infants. The average gestational age was 37.1± 2.8 weeks (29+2~39+3 weeks), and average birth weight was 2400±596 g (1370~3300 g). The mothers of 8 infants had prenatal fever, 8 had amniotic fluid pollution, and 6 had fetal distress. All the 9 patients had fever and 6 had tracheal intubation due to asphyxia or respiratory distress. Six patients had generalized maculopapular skin rash and 5 had convulsions. Increased white blood cell counts were found in 7 cases, increased monocyte proportion in 7 cases, and decreased platelet counts in 5 cases. The myocardial enzyme and liver enzyme were increased in 7 cases and C-reactive protein was significantly increased in 8 cases. Six patients received cerebrospinal fluid examination, and 5 had elevated cell counts and decreased glucose level. Blood culture showed gram-positive bacilli growth in all of 9 cases. One patient had ventricular enlargement and one had grade III intracranial hemorrhage. At the beginning, most infants were treated with third generation cephalosporin combined with penicillin or vancomycin, and antibiotics were changed to meropenem combined with penicillin or vancomycin according to blood culture results within 24 hours after admission. One patient was treated with meropenem combined with linezolid because of repeated fever and continuously elevated CRP. Six patients were cured and three died. Conclusions　Neonatal listeriosis is common in premature infants and can be characterized by outbreaks of infection and multiple organ damage. Because the results of antimicrobial susceptibility test in vitro are not completely consistent with those in vivo, the combination of antibiotics has a better bactericidal effect.

Key words: listeriosis;　sepsis;　treatment;　neonate