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1328. Paenibacillosis: An Emerging Cause of Neonatal Sepsis and Postinfectious Hydrocephalus

BACKGROUND: The etiology of neonatal sepsis is often not identified. Molecular methods can identify pathogens that culture-based methods miss. Most cases of neonatal sepsis globally are treated empirically per WHO guidelines with intravenous ampicillin and gentamicin, which may not be the best regim...

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Autores principales: Ericson, Jessica E, Burgoine, Kathy, Hehnly, Christine, Kumbakumba, Elias, Ochora, Moses, Bajunirwe, Francis, Bazira, Joel, Fronterre, Claudio, Hagmann, Cornelia, Kulkarni, Abhaya, Senthil Kumar, M, Magombe, Joshua, Mbabazi-Kabachelor, Edith, Morton, Sarah, Movassagh, Mercedeh, Mugamba, John, Mulondo, Ronald, Muwanguzi, Abraham, Natukwatsa, Davis, Kaaya, Brian Nsubuga, Olupot-Olupot, Peter, Onen, Justin, Sheldon, Kathryn, Smith, Jasmine, Ssentongo, Paddy, Ssenyonga, Peter, Warf, Benjamin, Wegoye, Emmanuel, Zhang, Lijun, Broach, James, Kiwanuka, Julius, Paulson, Joseph, Schiff, Steven
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9752957/
http://dx.doi.org/10.1093/ofid/ofac492.1158
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author Ericson, Jessica E
Burgoine, Kathy
Hehnly, Christine
Kumbakumba, Elias
Ochora, Moses
Bajunirwe, Francis
Bazira, Joel
Fronterre, Claudio
Hagmann, Cornelia
Kulkarni, Abhaya
Senthil Kumar, M
Magombe, Joshua
Mbabazi-Kabachelor, Edith
Morton, Sarah
Movassagh, Mercedeh
Mugamba, John
Mulondo, Ronald
Muwanguzi, Abraham
Natukwatsa, Davis
Kaaya, Brian Nsubuga
Olupot-Olupot, Peter
Onen, Justin
Sheldon, Kathryn
Smith, Jasmine
Ssentongo, Paddy
Ssenyonga, Peter
Warf, Benjamin
Wegoye, Emmanuel
Zhang, Lijun
Broach, James
Kiwanuka, Julius
Paulson, Joseph
Schiff, Steven
author_facet Ericson, Jessica E
Burgoine, Kathy
Hehnly, Christine
Kumbakumba, Elias
Ochora, Moses
Bajunirwe, Francis
Bazira, Joel
Fronterre, Claudio
Hagmann, Cornelia
Kulkarni, Abhaya
Senthil Kumar, M
Magombe, Joshua
Mbabazi-Kabachelor, Edith
Morton, Sarah
Movassagh, Mercedeh
Mugamba, John
Mulondo, Ronald
Muwanguzi, Abraham
Natukwatsa, Davis
Kaaya, Brian Nsubuga
Olupot-Olupot, Peter
Onen, Justin
Sheldon, Kathryn
Smith, Jasmine
Ssentongo, Paddy
Ssenyonga, Peter
Warf, Benjamin
Wegoye, Emmanuel
Zhang, Lijun
Broach, James
Kiwanuka, Julius
Paulson, Joseph
Schiff, Steven
author_sort Ericson, Jessica E
collection PubMed
description BACKGROUND: The etiology of neonatal sepsis is often not identified. Molecular methods can identify pathogens that culture-based methods miss. Most cases of neonatal sepsis globally are treated empirically per WHO guidelines with intravenous ampicillin and gentamicin, which may not be the best regimen for all pathogens. METHODS: We prospectively enrolled 800 neonates presenting with signs of sepsis to two Ugandan hospitals. Blood and cerebrospinal fluid were subjected to 16S rRNA sequencing, which identified Paenibacillus thiaminolyticus in 33/800 (4%) neonates. We confirmed the presence of P. thiaminolyticus by quantitative polymerase chain reaction (PCR). We describe neonatal and birth characteristics, presenting signs, and 12-month developmental outcomes for neonates with paenibacillosis. We performed antibiotic susceptibility testing and genomic analyses on three clinical isolates successfully grown in the laboratory. RESULTS: Neonates presented at a median age of 3 (1, 7) days. Fever (86%), irritability (78%) and seizures (52%) were common presenting signs (Figure). Most neonates were born vaginally (73%) at a medical facility (79%). Twelve (36%) had an adverse outcome: 5 (15%) neonates died; 4 (14%) survivors developed postinfectious hydrocephalus and three (9%) additional survivors had neurodevelopmental impairment. All three isolates were resistant to vancomycin, two were resistant to penicillin and ampicillin and one was unlikely to be sensitive to ceftriaxone; all were susceptible to gentamicin and meropenem. The genomes of all three strains contained multiple beta-lactamase genes and a cluster of genes that encodes a type IV pilus. Clinical signs at presentation for neonates with good and poor outcomes followng paenibacillosis [Figure: see text] CONCLUSION: Molecular methods such as 16S rRNA sequencing and PCR can be used to improve the identification of pathogens causing neonatal sepsis. Paenibacillosis is an important emerging cause of neonatal sepsis in Uganda and is likely an underrecognized cause of postinfectious hydrocephalus in the region and possibly elsewhere. Antibiotics commonly used for neonatal sepsis may be inadequate for the treatment of paenibacillosis. Additional studies to understand the pathophysiology and optimal treatment of this novel infection are urgently needed to prevent neonatal mortality and morbidity including postinfectious hydrocephalus. DISCLOSURES: Jessica E. Ericson, MD, MPH, Abbvie: Advisor/Consultant Abhaya Kulkarni, MD, MSc, PhD, Medtronic: Advisor/Consultant.
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spelling pubmed-97529572022-12-16 1328. Paenibacillosis: An Emerging Cause of Neonatal Sepsis and Postinfectious Hydrocephalus Ericson, Jessica E Burgoine, Kathy Hehnly, Christine Kumbakumba, Elias Ochora, Moses Bajunirwe, Francis Bazira, Joel Fronterre, Claudio Hagmann, Cornelia Kulkarni, Abhaya Senthil Kumar, M Magombe, Joshua Mbabazi-Kabachelor, Edith Morton, Sarah Movassagh, Mercedeh Mugamba, John Mulondo, Ronald Muwanguzi, Abraham Natukwatsa, Davis Kaaya, Brian Nsubuga Olupot-Olupot, Peter Onen, Justin Sheldon, Kathryn Smith, Jasmine Ssentongo, Paddy Ssenyonga, Peter Warf, Benjamin Wegoye, Emmanuel Zhang, Lijun Broach, James Kiwanuka, Julius Paulson, Joseph Schiff, Steven Open Forum Infect Dis Abstracts BACKGROUND: The etiology of neonatal sepsis is often not identified. Molecular methods can identify pathogens that culture-based methods miss. Most cases of neonatal sepsis globally are treated empirically per WHO guidelines with intravenous ampicillin and gentamicin, which may not be the best regimen for all pathogens. METHODS: We prospectively enrolled 800 neonates presenting with signs of sepsis to two Ugandan hospitals. Blood and cerebrospinal fluid were subjected to 16S rRNA sequencing, which identified Paenibacillus thiaminolyticus in 33/800 (4%) neonates. We confirmed the presence of P. thiaminolyticus by quantitative polymerase chain reaction (PCR). We describe neonatal and birth characteristics, presenting signs, and 12-month developmental outcomes for neonates with paenibacillosis. We performed antibiotic susceptibility testing and genomic analyses on three clinical isolates successfully grown in the laboratory. RESULTS: Neonates presented at a median age of 3 (1, 7) days. Fever (86%), irritability (78%) and seizures (52%) were common presenting signs (Figure). Most neonates were born vaginally (73%) at a medical facility (79%). Twelve (36%) had an adverse outcome: 5 (15%) neonates died; 4 (14%) survivors developed postinfectious hydrocephalus and three (9%) additional survivors had neurodevelopmental impairment. All three isolates were resistant to vancomycin, two were resistant to penicillin and ampicillin and one was unlikely to be sensitive to ceftriaxone; all were susceptible to gentamicin and meropenem. The genomes of all three strains contained multiple beta-lactamase genes and a cluster of genes that encodes a type IV pilus. Clinical signs at presentation for neonates with good and poor outcomes followng paenibacillosis [Figure: see text] CONCLUSION: Molecular methods such as 16S rRNA sequencing and PCR can be used to improve the identification of pathogens causing neonatal sepsis. Paenibacillosis is an important emerging cause of neonatal sepsis in Uganda and is likely an underrecognized cause of postinfectious hydrocephalus in the region and possibly elsewhere. Antibiotics commonly used for neonatal sepsis may be inadequate for the treatment of paenibacillosis. Additional studies to understand the pathophysiology and optimal treatment of this novel infection are urgently needed to prevent neonatal mortality and morbidity including postinfectious hydrocephalus. DISCLOSURES: Jessica E. Ericson, MD, MPH, Abbvie: Advisor/Consultant Abhaya Kulkarni, MD, MSc, PhD, Medtronic: Advisor/Consultant. Oxford University Press 2022-12-15 /pmc/articles/PMC9752957/ http://dx.doi.org/10.1093/ofid/ofac492.1158 Text en © The Author(s) 2022. Published by Oxford University Press on behalf of Infectious Diseases Society of America. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Abstracts
Ericson, Jessica E
Burgoine, Kathy
Hehnly, Christine
Kumbakumba, Elias
Ochora, Moses
Bajunirwe, Francis
Bazira, Joel
Fronterre, Claudio
Hagmann, Cornelia
Kulkarni, Abhaya
Senthil Kumar, M
Magombe, Joshua
Mbabazi-Kabachelor, Edith
Morton, Sarah
Movassagh, Mercedeh
Mugamba, John
Mulondo, Ronald
Muwanguzi, Abraham
Natukwatsa, Davis
Kaaya, Brian Nsubuga
Olupot-Olupot, Peter
Onen, Justin
Sheldon, Kathryn
Smith, Jasmine
Ssentongo, Paddy
Ssenyonga, Peter
Warf, Benjamin
Wegoye, Emmanuel
Zhang, Lijun
Broach, James
Kiwanuka, Julius
Paulson, Joseph
Schiff, Steven
1328. Paenibacillosis: An Emerging Cause of Neonatal Sepsis and Postinfectious Hydrocephalus
title 1328. Paenibacillosis: An Emerging Cause of Neonatal Sepsis and Postinfectious Hydrocephalus
title_full 1328. Paenibacillosis: An Emerging Cause of Neonatal Sepsis and Postinfectious Hydrocephalus
title_fullStr 1328. Paenibacillosis: An Emerging Cause of Neonatal Sepsis and Postinfectious Hydrocephalus
title_full_unstemmed 1328. Paenibacillosis: An Emerging Cause of Neonatal Sepsis and Postinfectious Hydrocephalus
title_short 1328. Paenibacillosis: An Emerging Cause of Neonatal Sepsis and Postinfectious Hydrocephalus
title_sort 1328. paenibacillosis: an emerging cause of neonatal sepsis and postinfectious hydrocephalus
topic Abstracts
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9752957/
http://dx.doi.org/10.1093/ofid/ofac492.1158
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