Department of Pediatrics, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan; Department of Pediatrics, Changhua Christian Children's Hospital, Changhua City, Taiwan.
Department of Pediatrics, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.
J Microbiol Immunol Infect. 2021 Dec;54(6):1078-1085. doi: 10.1016/j.jmii.2020.07.004. Epub 2020 Jul 28.
BACKGROUND/PURPOSE: Although Streptococcus gallolyticus subspecies pasteurianus (SGSP) is a rare pathogen in children, it can cause invasive infections among neonates and infants. Herein, we report bacteremia/meningitis caused by SGSP in three neonates and review the literature on bacteremia and/or meningitis caused by this organism.
Three neonates, referred from an obstetrics clinic within a 2-month period, presented with invasive SGSP infections. The bacterial isolates were analyzed using Bruker Biotyper MALDI-TOF, sequencing of 16S rRNA and sodA genes (encoding manganese dependent superoxide dismutase), and PCR restriction fragment length polymorphism assay of groESL gene. Molecular typing was performed to evaluate the genetic relatedness.
The median onset age of infection in the three neonates was 3 days (range 2-5 days). They were delivered through cesarean section in the same operation room under different doctors, and were cared for by different nurses. Patient A presented with bacteremia, patient B with bacteremia and meningitis, and patient C with meningitis. Four isolates were identified as SGSP and were susceptible to penicillin G, cefotaxime, and vancomycin. All patients were treated with ampicillin plus cefotaxime for 14 days, and no complications were observed. The molecular typing results suggested that all isolates belonged to a single clone, which indicated the possibility of an outbreak in the obstetrics clinic.
Infection by a rare pathogen such as SGSP in multiple patients belonging to a single healthcare unit indicates that detailed investigation and stringent infection control policy are necessary for preventing further outbreaks of such diseases.
背景/目的：虽然化脓性链球菌亚种巴氏亚种（SGSP）在儿童中是一种罕见的病原体，但它可引起新生儿和婴儿的侵袭性感染。在此，我们报告了三例由 SGSP 引起的菌血症/脑膜炎，并回顾了该病原体引起的菌血症和/或脑膜炎的文献。
在两个月的时间内，从一家妇产科诊所转来的 3 名新生儿患有侵袭性 SGSP 感染。使用 Bruker Biotyper MALDI-TOF、16S rRNA 和 sodA 基因（编码锰依赖性超氧化物歧化酶）测序以及 groESL 基因的 PCR 限制性片段长度多态性分析对细菌分离株进行分析。进行分子分型以评估遗传相关性。
三名新生儿感染的中位发病年龄为 3 天（范围 2-5 天）。他们均在同一家手术室行剖宫产分娩，由不同的医生操作，由不同的护士护理。患者 A 表现为菌血症，患者 B 表现为菌血症和脑膜炎，患者 C 表现为脑膜炎。4 株分离株被鉴定为 SGSP，对青霉素 G、头孢噻肟和万古霉素敏感。所有患者均接受氨苄西林联合头孢噻肟治疗 14 天，未观察到并发症。分子分型结果表明，所有分离株均属于单一克隆，这表明妇产科可能发生了暴发。
单一医疗机构中多例罕见病原体（如 SGSP）感染表明，需要进行详细调查和严格的感染控制政策，以防止此类疾病的进一步暴发。
