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Paenibacillus spp infection among infants with postinfectious hydrocephalus in Uganda: an observational case-control study

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Paenibacillus spp infection among infants with postinfectious hydrocephalus in Uganda: an observational case-control study. / Morton, Sarah U; Hehnly, Christine; Burgoine, Kathy et al.
In: The Lancet. Microbe, Vol. 4, No. 8, 31.08.2023, p. e601-e611.

Research output: Contribution to Journal/Magazine › Journal article › peer-review

Harvard

Morton, SU, Hehnly, C, Burgoine, K, Ssentongo, P, Ericson, JE, Kumar, MS, Hagmann, C, Fronterre, C, Smith, J, Movassagh, M, Streck, N, Bebell, LM, Bazira, J, Kumbakumba, E, Bajunirwe, F, Mulondo, R, Mbabazi-Kabachelor, E, Nsubuga, BK, Natukwatsa, D, Nalule, E, Magombe, J, Erickson, T, Ngonzi, J, Ochora, M, Olupot-Olupot, P, Onen, J, Ssenyonga, P, Mugamba, J, Warf, BC, Kulkarni, AV, Lane, J, Whalen, AJ, Zhang, L, Sheldon, K, Meier, FA, Kiwanuka, J, Broach, JR, Paulson, JN & Schiff, SJ 2023, 'Paenibacillus spp infection among infants with postinfectious hydrocephalus in Uganda: an observational case-control study', The Lancet. Microbe, vol. 4, no. 8, pp. e601-e611. https://doi.org/10.1016/S2666-5247(23)00106-4

APA

Morton, S. U., Hehnly, C., Burgoine, K., Ssentongo, P., Ericson, J. E., Kumar, M. S., Hagmann, C., Fronterre, C., Smith, J., Movassagh, M., Streck, N., Bebell, L. M., Bazira, J., Kumbakumba, E., Bajunirwe, F., Mulondo, R., Mbabazi-Kabachelor, E., Nsubuga, B. K., Natukwatsa, D., ... Schiff, S. J. (2023). Paenibacillus spp infection among infants with postinfectious hydrocephalus in Uganda: an observational case-control study. The Lancet. Microbe, 4(8), e601-e611. https://doi.org/10.1016/S2666-5247(23)00106-4

Vancouver

Morton SU, Hehnly C, Burgoine K, Ssentongo P, Ericson JE, Kumar MS et al. Paenibacillus spp infection among infants with postinfectious hydrocephalus in Uganda: an observational case-control study. The Lancet. Microbe. 2023 Aug 31;4(8):e601-e611. doi: 10.1016/S2666-5247(23)00106-4

Author

Morton, Sarah U ; Hehnly, Christine ; Burgoine, Kathy et al. / Paenibacillus spp infection among infants with postinfectious hydrocephalus in Uganda : an observational case-control study. In: The Lancet. Microbe. 2023 ; Vol. 4, No. 8. pp. e601-e611.

Bibtex

@article{4e72f12a2bc44e4bba11b9b7ce0b7787,
title = "Paenibacillus spp infection among infants with postinfectious hydrocephalus in Uganda: an observational case-control study",
abstract = "Paenibacillus thiaminolyticus is a cause of postinfectious hydrocephalus among Ugandan infants. To determine whether Paenibacillus spp is a pathogen in neonatal sepsis, meningitis, and postinfectious hydrocephalus, we aimed to complete three separate studies of Ugandan infants. The first study was on peripartum prevalence of Paenibacillus in mother-newborn pairs. The second study assessed Paenibacillus in blood and cerebrospinal fluid (CSF) from neonates with sepsis. The third study assessed Paenibacillus in CSF from infants with hydrocephalus. In this observational study, we recruited mother-newborn pairs with and without maternal fever (mother-newborn cohort), neonates (aged ≤28 days) with sepsis (sepsis cohort), and infants (aged ≤90 days) with hydrocephalus with and without a history of neonatal sepsis and meningitis (hydrocephalus cohort) from three hospitals in Uganda between Jan 13, 2016 and Oct 2, 2019. We collected maternal blood, vaginal swabs, and placental samples and the cord from the mother-newborn pairs, and blood and CSF from neonates and infants. Bacterial content of infant CSF was characterised by 16S rDNA sequencing. We analysed all samples using quantitative PCR (qPCR) targeting either the Paenibacillus genus or Paenibacillus thiaminolyticus spp. We collected cranial ultrasound and computed tomography images in the subset of participants represented in more than one cohort. No Paenibacillus spp were detected in vaginal, maternal blood, placental, or cord blood specimens from the mother-newborn cohort by qPCR. Paenibacillus spp was detected in 6% (37 of 631 neonates) in the sepsis cohort and, of these, 14% (5 of 37 neonates) developed postinfectious hydrocephalus. Paenibacillus was the most enriched bacterial genera in postinfectious hydrocephalus CSF (91 [44%] of 209 patients) from the hydrocephalus cohort, with 16S showing 94% accuracy when validated by qPCR. Imaging showed progression from Paenibacillus spp-related meningitis to postinfectious hydrocephalus over 1-3 months. Patients with postinfectious hydrocephalus with Paenibacillus spp infections were geographically clustered. Paenibacillus spp causes neonatal sepsis and meningitis in Uganda and is the dominant cause of subsequent postinfectious hydrocephalus. There was no evidence of transplacental transmission, and geographical evidence was consistent with an environmental source of neonatal infection. Further work is needed to identify routes of infection and optimise treatment of neonatal Paenibacillus spp infection to lessen the burden of morbidity and mortality. National Institutes of Health and Boston Children's Hospital Office of Faculty Development.",
keywords = "Case-Control Studies, Child, Female, Humans, Hydrocephalus/epidemiology, Infant, Infant, Newborn, Meningitis/complications, Neonatal Sepsis/complications, Paenibacillus/genetics, Placenta, Pregnancy, Sepsis/complications, Uganda/epidemiology, United States",
author = "Morton, {Sarah U} and Christine Hehnly and Kathy Burgoine and Paddy Ssentongo and Ericson, {Jessica E} and Kumar, {M Senthil} and Cornelia Hagmann and Claudio Fronterre and Jasmine Smith and Mercedeh Movassagh and Nicholas Streck and Bebell, {Lisa M} and Joel Bazira and Elias Kumbakumba and Francis Bajunirwe and Ronald Mulondo and Edith Mbabazi-Kabachelor and Nsubuga, {Brian K} and Davis Natukwatsa and Esther Nalule and Joshua Magombe and Tim Erickson and Joseph Ngonzi and Moses Ochora and Peter Olupot-Olupot and Justin Onen and Peter Ssenyonga and John Mugamba and Warf, {Benjamin C} and Kulkarni, {Abhaya V} and Jessica Lane and Whalen, {Andrew J} and Lijun Zhang and Kathryn Sheldon and Meier, {Frederick A} and Julius Kiwanuka and Broach, {James R} and Paulson, {Joseph N} and Schiff, {Steven J}",
year = "2023",
month = aug,
day = "31",
doi = "10.1016/S2666-5247(23)00106-4",
language = "English",
volume = "4",
pages = "e601--e611",
journal = "The Lancet. Microbe",
issn = "2666-5247",
publisher = "Elsevier Ltd",
number = "8",

}

RIS

TY - JOUR

T1 - Paenibacillus spp infection among infants with postinfectious hydrocephalus in Uganda

T2 - an observational case-control study

AU - Morton, Sarah U

AU - Hehnly, Christine

AU - Burgoine, Kathy

AU - Ssentongo, Paddy

AU - Ericson, Jessica E

AU - Kumar, M Senthil

AU - Hagmann, Cornelia

AU - Fronterre, Claudio

AU - Smith, Jasmine

AU - Movassagh, Mercedeh

AU - Streck, Nicholas

AU - Bebell, Lisa M

AU - Bazira, Joel

AU - Kumbakumba, Elias

AU - Bajunirwe, Francis

AU - Mulondo, Ronald

AU - Mbabazi-Kabachelor, Edith

AU - Nsubuga, Brian K

AU - Natukwatsa, Davis

AU - Nalule, Esther

AU - Magombe, Joshua

AU - Erickson, Tim

AU - Ngonzi, Joseph

AU - Ochora, Moses

AU - Olupot-Olupot, Peter

AU - Onen, Justin

AU - Ssenyonga, Peter

AU - Mugamba, John

AU - Warf, Benjamin C

AU - Kulkarni, Abhaya V

AU - Lane, Jessica

AU - Whalen, Andrew J

AU - Zhang, Lijun

AU - Sheldon, Kathryn

AU - Meier, Frederick A

AU - Kiwanuka, Julius

AU - Broach, James R

AU - Paulson, Joseph N

AU - Schiff, Steven J

PY - 2023/8/31

Y1 - 2023/8/31

N2 - Paenibacillus thiaminolyticus is a cause of postinfectious hydrocephalus among Ugandan infants. To determine whether Paenibacillus spp is a pathogen in neonatal sepsis, meningitis, and postinfectious hydrocephalus, we aimed to complete three separate studies of Ugandan infants. The first study was on peripartum prevalence of Paenibacillus in mother-newborn pairs. The second study assessed Paenibacillus in blood and cerebrospinal fluid (CSF) from neonates with sepsis. The third study assessed Paenibacillus in CSF from infants with hydrocephalus. In this observational study, we recruited mother-newborn pairs with and without maternal fever (mother-newborn cohort), neonates (aged ≤28 days) with sepsis (sepsis cohort), and infants (aged ≤90 days) with hydrocephalus with and without a history of neonatal sepsis and meningitis (hydrocephalus cohort) from three hospitals in Uganda between Jan 13, 2016 and Oct 2, 2019. We collected maternal blood, vaginal swabs, and placental samples and the cord from the mother-newborn pairs, and blood and CSF from neonates and infants. Bacterial content of infant CSF was characterised by 16S rDNA sequencing. We analysed all samples using quantitative PCR (qPCR) targeting either the Paenibacillus genus or Paenibacillus thiaminolyticus spp. We collected cranial ultrasound and computed tomography images in the subset of participants represented in more than one cohort. No Paenibacillus spp were detected in vaginal, maternal blood, placental, or cord blood specimens from the mother-newborn cohort by qPCR. Paenibacillus spp was detected in 6% (37 of 631 neonates) in the sepsis cohort and, of these, 14% (5 of 37 neonates) developed postinfectious hydrocephalus. Paenibacillus was the most enriched bacterial genera in postinfectious hydrocephalus CSF (91 [44%] of 209 patients) from the hydrocephalus cohort, with 16S showing 94% accuracy when validated by qPCR. Imaging showed progression from Paenibacillus spp-related meningitis to postinfectious hydrocephalus over 1-3 months. Patients with postinfectious hydrocephalus with Paenibacillus spp infections were geographically clustered. Paenibacillus spp causes neonatal sepsis and meningitis in Uganda and is the dominant cause of subsequent postinfectious hydrocephalus. There was no evidence of transplacental transmission, and geographical evidence was consistent with an environmental source of neonatal infection. Further work is needed to identify routes of infection and optimise treatment of neonatal Paenibacillus spp infection to lessen the burden of morbidity and mortality. National Institutes of Health and Boston Children's Hospital Office of Faculty Development.

AB - Paenibacillus thiaminolyticus is a cause of postinfectious hydrocephalus among Ugandan infants. To determine whether Paenibacillus spp is a pathogen in neonatal sepsis, meningitis, and postinfectious hydrocephalus, we aimed to complete three separate studies of Ugandan infants. The first study was on peripartum prevalence of Paenibacillus in mother-newborn pairs. The second study assessed Paenibacillus in blood and cerebrospinal fluid (CSF) from neonates with sepsis. The third study assessed Paenibacillus in CSF from infants with hydrocephalus. In this observational study, we recruited mother-newborn pairs with and without maternal fever (mother-newborn cohort), neonates (aged ≤28 days) with sepsis (sepsis cohort), and infants (aged ≤90 days) with hydrocephalus with and without a history of neonatal sepsis and meningitis (hydrocephalus cohort) from three hospitals in Uganda between Jan 13, 2016 and Oct 2, 2019. We collected maternal blood, vaginal swabs, and placental samples and the cord from the mother-newborn pairs, and blood and CSF from neonates and infants. Bacterial content of infant CSF was characterised by 16S rDNA sequencing. We analysed all samples using quantitative PCR (qPCR) targeting either the Paenibacillus genus or Paenibacillus thiaminolyticus spp. We collected cranial ultrasound and computed tomography images in the subset of participants represented in more than one cohort. No Paenibacillus spp were detected in vaginal, maternal blood, placental, or cord blood specimens from the mother-newborn cohort by qPCR. Paenibacillus spp was detected in 6% (37 of 631 neonates) in the sepsis cohort and, of these, 14% (5 of 37 neonates) developed postinfectious hydrocephalus. Paenibacillus was the most enriched bacterial genera in postinfectious hydrocephalus CSF (91 [44%] of 209 patients) from the hydrocephalus cohort, with 16S showing 94% accuracy when validated by qPCR. Imaging showed progression from Paenibacillus spp-related meningitis to postinfectious hydrocephalus over 1-3 months. Patients with postinfectious hydrocephalus with Paenibacillus spp infections were geographically clustered. Paenibacillus spp causes neonatal sepsis and meningitis in Uganda and is the dominant cause of subsequent postinfectious hydrocephalus. There was no evidence of transplacental transmission, and geographical evidence was consistent with an environmental source of neonatal infection. Further work is needed to identify routes of infection and optimise treatment of neonatal Paenibacillus spp infection to lessen the burden of morbidity and mortality. National Institutes of Health and Boston Children's Hospital Office of Faculty Development.

KW - Case-Control Studies

KW - Child

KW - Female

KW - Humans

KW - Hydrocephalus/epidemiology

KW - Infant

KW - Infant, Newborn

KW - Meningitis/complications

KW - Neonatal Sepsis/complications

KW - Paenibacillus/genetics

KW - Placenta

KW - Pregnancy

KW - Sepsis/complications

KW - Uganda/epidemiology

KW - United States

U2 - 10.1016/S2666-5247(23)00106-4

DO - 10.1016/S2666-5247(23)00106-4

M3 - Journal article

C2 - 37348522

VL - 4

SP - e601-e611

JO - The Lancet. Microbe

JF - The Lancet. Microbe

SN - 2666-5247

IS - 8

ER -