Neonatal Paenibacilliosis: Paenibacillus Infection as a Novel Cause of Sepsis in Term Neonates With High Risk of Sequelae in Uganda.

Autor:	Ericson JE; Department of Pediatrics, Penn State College of Medicine, Hershey, Pennsylvania, USA., Burgoine K; Department of Paediatrics and Child Health, Mbale Regional Referral Hospital, Mbale, Uganda.; Institute of Translational Medicine, University of Liverpool, Liverpool, United Kingdom.; Mbale Clinical Research Institute, Mbale Regional Referral Hospital, Mbale, Uganda., Kumbakumba E; Department of Pediatrics and Child Health, Mbarara University of Science and Technology, Mbarara, Uganda., Ochora M; Department of Pediatrics and Child Health, Mbarara University of Science and Technology, Mbarara, Uganda., Hehnly C; Department of Pediatrics, Penn State College of Medicine, Hershey, Pennsylvania, USA., Bajunirwe F; Department of Pediatrics and Child Health, Mbarara University of Science and Technology, Mbarara, Uganda., Bazira J; Department of Pediatrics and Child Health, Mbarara University of Science and Technology, Mbarara, Uganda., Fronterre C; Lancaster Medical School, Lancaster University, Lancaster, United Kingdom., Hagmann C; Neonatology, University Children's Hospital Zurich, Zurich, Switzerland., Kulkarni AV; Department of Surgery, Hospital for Sick Children, University of Toronto, Toronto, Canada., Kumar MS; Harvard T.H. Chan School of Public Health, Dana Farber Cancer Institute, Boston, Massachusetts, USA., Magombe J; CURE Children's Hospital of Uganda, Mbale, Uganda., Mbabazi-Kabachelor E; CURE Children's Hospital of Uganda, Mbale, Uganda., Morton SU; Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts, USA., Movassagh M; Harvard T.H. Chan School of Public Health, Dana Farber Cancer Institute, Boston, Massachusetts, USA.; Department of Neurosurgery, Yale University School of Medicine, New Haven, Connecticut, USA., Mugamba J; CURE Children's Hospital of Uganda, Mbale, Uganda., Mulondo R; CURE Children's Hospital of Uganda, Mbale, Uganda., Natukwatsa D; CURE Children's Hospital of Uganda, Mbale, Uganda., Kaaya BN; CURE Children's Hospital of Uganda, Mbale, Uganda., Olupot-Olupot P; Mbale Clinical Research Institute, Mbale Regional Referral Hospital, Mbale, Uganda.; Department of Public Health, Busitema University, Busitema, Uganda., Onen J; CURE Children's Hospital of Uganda, Mbale, Uganda., Sheldon K; Department of Pediatrics, Penn State College of Medicine, Hershey, Pennsylvania, USA., Smith J; Department of Pediatrics, Penn State College of Medicine, Hershey, Pennsylvania, USA., Ssentongo P; Department of Pediatrics, Penn State College of Medicine, Hershey, Pennsylvania, USA., Ssenyonga P; CURE Children's Hospital of Uganda, Mbale, Uganda., Warf B; Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts, USA., Wegoye E; CURE Children's Hospital of Uganda, Mbale, Uganda., Zhang L; Case Western Reserve University School of Medicine, Cleveland, Ohio, USA., Kiwanuka J; Department of Pediatrics and Child Health, Mbarara University of Science and Technology, Mbarara, Uganda., Paulson JN; N-Power Medicine, Inc., Redwood City, California, USA., Broach JR; Department of Pediatrics, Penn State College of Medicine, Hershey, Pennsylvania, USA., Schiff SJ; Department of Neurosurgery, Yale University School of Medicine, New Haven, Connecticut, USA.
Jazyk:	angličtina
Zdroj:	Clinical infectious diseases : an official publication of the Infectious Diseases Society of America [Clin Infect Dis] 2023 Sep 11; Vol. 77 (5), pp. 768-775.
DOI:	10.1093/cid/ciad337
Abstrakt:	Background: Paenibacillus thiaminolyticus may be an underdiagnosed cause of neonatal sepsis. Methods: We prospectively enrolled a cohort of 800 full-term neonates presenting with a clinical diagnosis of sepsis at 2 Ugandan hospitals. Quantitative polymerase chain reaction specific to P. thiaminolyticus and to the Paenibacillus genus were performed on the blood and cerebrospinal fluid (CSF) of 631 neonates who had both specimen types available. Neonates with Paenibacillus genus or species detected in either specimen type were considered to potentially have paenibacilliosis, (37/631, 6%). We described antenatal, perinatal, and neonatal characteristics, presenting signs, and 12-month developmental outcomes for neonates with paenibacilliosis versus clinical sepsis due to other causes. Results: Median age at presentation was 3 days (interquartile range 1, 7). Fever (92%), irritability (84%), and clinical signs of seizures (51%) were common. Eleven (30%) had an adverse outcome: 5 (14%) neonates died during the first year of life; 5 of 32 (16%) survivors developed postinfectious hydrocephalus (PIH) and 1 (3%) additional survivor had neurodevelopmental impairment without hydrocephalus. Conclusions: Paenibacillus species was identified in 6% of neonates with signs of sepsis who presented to 2 Ugandan referral hospitals; 70% were P. thiaminolyticus. Improved diagnostics for neonatal sepsis are urgently needed. Optimal antibiotic treatment for this infection is unknown but ampicillin and vancomycin will be ineffective in many cases. These results highlight the need to consider local pathogen prevalence and the possibility of unusual pathogens when determining antibiotic choice for neonatal sepsis. Competing Interests: Potential conflicts of interest. J. N. P. received salary support and stock/stock options from Genentech and N-Power Medicine. He has patents planned, issued, or pending with Genentech and N-Power Medicine. He received honoraria for lectures from the International Human Microbiome Consortia. J. E. E. received consulting fees from AbbVie for participation in a data safety and monitoring board unrelated to the current work. All other authors report no potential conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed. (© The Author(s) 2023. Published by Oxford University Press on behalf of Infectious Diseases Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
Databáze:	MEDLINE
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