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.

Methods

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.

Results

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.

Conclusion

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.

中文翻译：

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溶血性链球菌巴氏杆菌亚种菌血症和新生儿脑膜炎的聚集

背景/目的

虽然链球菌gallolyticus亚种巴氏（SGSP）是儿童罕见的病原菌，可引起新生儿和婴儿的侵袭性感染。在此，我们报告了三名新生儿由 SGSP 引起的菌血症/脑膜炎，并回顾了有关由该微生物引起的菌血症和/或脑膜炎的文献。

方法

三名新生儿在 2 个月内从产科诊所转诊，出现侵袭性 SGSP 感染。使用 Bruker Biotyper MALDI-TOF、16S rRNA 和sod A 基因（编码锰依赖性超氧化物歧化酶）测序和gro ESL 基因的PCR 限制性片段长度多态性分析对细菌分离物进行分析。进行分子分型以评估遗传相关性。

结果

三名新生儿感染的中位发病年龄为 3 天（范围 2-5 天）。他们在同一手术室由不同的医生剖宫产，由不同的护士照顾。患者 A 出现菌血症，患者 B 出现菌血症和脑膜炎，患者 C 出现脑膜炎。四个分离株被鉴定为 SGSP，并对青霉素 G、头孢噻肟和万古霉素敏感。所有患者均给予氨苄青霉素联合头孢噻肟治疗14天，未出现并发症。分子分型结果表明，所有分离株均属于单一克隆，这表明产科诊所可能爆发疫情。

结论

属于同一医疗单位的多名患者感染 SGSP 等罕见病原体表明，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爆发。