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13 SDC 2 Demographic and clinical characteristics of 22 documented cases of neonatal melioidosis sorted by year of publication Ca Country, Se Onset GA BW Mode of se year x (days) (wee (g) transmiss 1 US, M 19714 2 Thailand, 2 (37 ks) ion Term 2,977 NA† h) M 14 33 1,230 HCAI Clinical features Thailand, F 14 32 1,370 HCAI 19888 4 Thailand, 19888 F IAB 32 1,340 NA Treatment and duration Outcome of antibiotics therapy Poor feeding, - B. pseudomallei - Surgery at 3 h after Died (119 h lethargy, fever, sepsis and meningitis birth after birth) jaundice, - Depressed right - Polymyxin B grunting frontal skull fracture. (parenterally and - Pneumonia intrathecally), 9 h - B. pseudomallei and - Cefotaxime and Klebsiella sepsis gentamicin, 14 d RD, apnea, - B. pseudomallei - Ceftazidime, 20 d Recovered lethargy sepsis, sterile CSF Asymptomatic - B. pseudomallei - Penicillin and Recovered sepsis gentamicin, 10 d Asymptomatic 19888 3 Diagnosis Recovered 14 5 Thailand, M IAB 19888 Prete 1,330 NA Severe RD rm - B. pseudomallei - Penicillin and Died (20 h sepsis gentamicin, 20 h after birth) - Cefotaxime, 4 h Died (9th date - Respiratory distress syndrome 6 Thailand, M 5 19888 Prete 1,600 HCAI Apnea rm - B. pseudomallei meningitis and of life) Candida sepsis - Pneumonia 7 8 Malaysia, M 2 (30 19933 h) Malaysia, M 19987 10 Term 3,400 Term 3,200 HCAI CAI RD, lethargy, - B. pseudomallei and - Penicillin and Died (5th date poor feeding Acinetobacter sepsis gentamicin, 1 d then of life) and diffuse - Septic shock and - Ticarcillin and macular rash bronchopneumonia gentamicin, 2 d RD, fever, - B. pseudomallei - Cloxacillin and Died (20 h cough, lethargy, sepsis gentamicin after poor feeding - Septic shock, bronchopneumonia admission) 15 9 Malaysia, M 8 Term 3,600 CAI 19987 10 Netherla F 2 32 1,850 Transmit Fever, - B. pseudomallei - Cefotaxime and irritability, sepsis and meningitis gentamicin, then tachypnea, - Pneumonia and - Ceftazidime, 3 weeks convulsion omphalitis RD, sepsis - B. pseudomallei - Ceftazidime, 8 weeks nds, ted from sepsis and pneumonia then 20011 mother- - Right lung abscess - Amoxicillin- to-child‡ 11 Australia, M 2 37 3,020 20049 12- Thailand, 19 200410 20 Malaysia, F 20052 NA NA 8 NA NA Term 2,700 Recovered Recovered clavulanate, 6 weeks Transmit Fever, - B. pseudomallei - Ampicillin and Died (5th date ted from tachypnea, sepsis gentamicin of life) mother- bradycardia, - Septic shock and to-child§ hypotension respiratory failure NA Fever (100%), - B. pseudomallei NA All died peritonitis (2/8) sepsis Fever, RD, - B. pseudomallei - Cefotaxime (200 Died (30th vomiting, sepsis and pneumonia mg/kg/day) and date of life) CAI 16 lethargy, poor - Acute Respiratory piperacillin (200 feeding, pale, distress syndrome mg/kg/day), 2 d then hypotension - Ceftazidime 50 mg/kg/dose q 12 h 21 India, F IAB 35 1,900 NA* 20095 Fever, grunting, - B. pseudomallei - Ceftriaxone and tachypnea, sepsis gentamicin, 1 d then lethargy, poor - Bronchopneumonia - Ceftazidime and peripheral vancomycin, 10 d then perfusion amoxicillin- Recovered clavulanate, 2 weeks 22 Thailand, 20116 M 21 Term 2,500 CAI Fever, - B. pseudomallei and - Cloxacillin (200 Died (27th hematemesis, methicillin-susceptible mg/kg/day), 6 d date of life) melena, Staphylococcus aureus lethargy, seizure sepsis - Septic shock 17 CAI indicates community-acquired infection; F, Female; HCAI, healthcare-associated infection; IAB, immediately after birth; M, male; NA, not available; RD, respiratory distress † Cultures of the mother's urogenital tract were negative for B. pseudomallei. The father had recent military service in Vietnam, but he had no contact with the infant. The maternal grandmother had diabetes mellitus. ‡ Placental microabscesses, on prednisone due to ulcerative colitis and had vacation to Thailand. Cervical culture showed B. pseudomallei with both IgG and IgM enzyme immunoassay were reactive § Mastitis at 2nd date before delivery, B. pseudomallei total antibody titer of 1/160 by indirect hemagglutination inhibition with both IgG and IgM enzyme immunoassay were reactive *Vaginal swab of the mother or environmental samples from the NICU were not recovered B. pseudomallei