Unexpected Clinical Course in Neonatal Sepsis: A Case of <i>Escherichia coli</i> and <i>Pseudomonas aeruginosa</i> Co-infection

Abstract

Introduction: Despite substantial advances in infection control for infants, neonatal sepsis remains a major cause of morbidity and mortality, particularly in pediatric intensive care units (PICUs). Case Presentation: A 49-day-old female infant was admitted to Hakim Hospital with respiratory symptoms. Clinical signs suggestive of pertussis prompted the initiation of empirical antibiotic therapy. Blood cultures subsequently grew Escherichia coli (E. coli) and Pseudomonas aeruginosa (P. aeruginosa), both of which were susceptible to most tested antibiotics, including carbapenems and aminoglycosides. Despite appropriate antibiotic treatment, the patient’s condition deteriorated, and she died 9 days after admission. Conclusions: This case highlights that, in neonatal sepsis, favorable in vitro antibiotic susceptibility does not necessarily predict a successful clinical outcome. Additional host-, pathogen-, and treatment-related factors should be considered when evaluating treatment failure and mortality in critically ill infants.