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Depta F, Pažitný M, Trebišovský M, Maďarová T, Deptová J. Infective endocarditis caused by Paenibacillus thiaminolyticus: a case report and review of literature. Eur Heart J Case Rep 2023; 7:ytad566. [PMID: 38034940 PMCID: PMC10686528 DOI: 10.1093/ehjcr/ytad566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 11/03/2023] [Accepted: 11/14/2023] [Indexed: 12/02/2023]
Abstract
Background Paenibacillus constitutes a genus of gram-positive, facultatively anaerobic, rod-shaped bacteria that act as potentially opportunistic pathogens. With only a few documented case studies to date, Paenibacillus species are rarely the cause of a disease in humans. Case summary We report a case involving a 64-year-old male with known mild mitral regurgitation, who presented with fever and dyspnoea. Initially treated with empirical antibiotics, his blood cultures cultivated Paenibacillus thiaminolyticus, a previously unreported cause of endocarditis. Transoesophageal echocardiography demonstrated vegetations on the both leaflets of mitral valve along with severe mitral regurgitation, thus confirming a diagnosis of endocarditis. The patient was referred for cardiac surgery; however, the procedure was delayed due to complications related to a known hepatic cyst and additionally contraction of COVID-19 infection. The patient subsequently underwent mitral valve replacement without complications. Discussion Because of its rarity, guidelines to recommend specific antibiotics to treat Paenibacillus infective endocarditis are absent. To confirm the pathogen, molecular methods such as mass spectrometry or 16S rRNA sequencing are required. Early targeted antibiotic therapy and cardiac surgery are warranted to achieve good clinical outcomes.
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Affiliation(s)
- Filip Depta
- Department of Critical Care, East Slovak Institute for Cardiovascular Diseases, Ondavská 8, Košice 040 11, Slovakia
- Medical Faculty, Pavol Jozef Šafárik University, Trieda SNP 1, Košice 040 11, Slovakia
| | - Martin Pažitný
- Department of Critical Care, East Slovak Institute for Cardiovascular Diseases, Ondavská 8, Košice 040 11, Slovakia
- Medical Faculty, Pavol Jozef Šafárik University, Trieda SNP 1, Košice 040 11, Slovakia
| | - Michal Trebišovský
- Medical Faculty, Pavol Jozef Šafárik University, Trieda SNP 1, Košice 040 11, Slovakia
- Department of Cardiac Surgery, East Slovak Institute for Cardiovascular Diseases, Košice, Slovakia
| | - Tatiana Maďarová
- Department of Cardiac Surgery, East Slovak Institute for Cardiovascular Diseases, Košice, Slovakia
- St.Elizabeth College of Health and Social Work, Námestia 1. mája 1, Bratislava 811 06, Slovakia
| | - Jana Deptová
- Medical Faculty, Pavol Jozef Šafárik University, Trieda SNP 1, Košice 040 11, Slovakia
- Department of Internal Medicine, Louis Pasteur University Hospital, Košice, Slovakia
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Smith D, Bastug K, Burgoine K, Broach JR, Hehnly C, Morton SU, Osman M, Schiff SJ, Ericson JE. Human Paenibacillus Infections: A Systematic Review with Comparison of Adult and Infant Cases. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.09.19.23295794. [PMID: 37790370 PMCID: PMC10543034 DOI: 10.1101/2023.09.19.23295794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
Neonatal infections due to Paenibacillus species have increasingly been reported over the last few years. We performed a structured literature review of human Paenibacillus infections in infants and adults to compare the epidemiology of infections between these distinct patient populations. Thirty-nine reports describing 176 infections met our inclusion criteria and were included. There were 37 Paenibacillus infections occurring in adults caused by 23 species. The clinical presentations of infections were quite variable. In contrast, infections in infants were caused by only 3 species: P. thiaminolyticus (112/139, 80%), P. alvei (2/139, 1%) and P. dendritiformis (2/139, 1%). All of the infants with Paenibacillus infection presented with a sepsis syndrome or meningitis, often complicated by extensive cerebral destruction and hydrocephalus. Outcomes were commonly poor with 17% (24/139) mortality. Cystic encephalomalacia due to brain destruction was common in both Ugandan and American cases and 92/139 (66%) required surgical management of hydrocephalus following their infection. Paenibacillus infections are likely underappreciated in infants and effective treatments are urgently needed.
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Ericson JE, Burgoine K, Kumbakumba E, Ochora M, Hehnly C, Bajunirwe F, Bazira J, Fronterre C, Hagmann C, Kulkarni AV, Kumar MS, Magombe J, Mbabazi-Kabachelor E, Morton SU, Movassagh M, Mugamba J, Mulondo R, Natukwatsa D, Kaaya BN, Olupot-Olupot P, Onen J, Sheldon K, Smith J, Ssentongo P, Ssenyonga P, Warf B, Wegoye E, Zhang L, Kiwanuka J, Paulson JN, Broach JR, Schiff SJ. Neonatal Paenibacilliosis: Paenibacillus Infection as a Novel Cause of Sepsis in Term Neonates With High Risk of Sequelae in Uganda. Clin Infect Dis 2023; 77:768-775. [PMID: 37279589 PMCID: PMC10495130 DOI: 10.1093/cid/ciad337] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 03/31/2023] [Accepted: 05/31/2023] [Indexed: 06/08/2023] Open
Abstract
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.
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Affiliation(s)
- Jessica E Ericson
- Department of Pediatrics, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Kathy Burgoine
- 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
| | - Elias Kumbakumba
- Department of Pediatrics and Child Health, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Moses Ochora
- Department of Pediatrics and Child Health, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Christine Hehnly
- Department of Pediatrics, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Francis Bajunirwe
- Department of Pediatrics and Child Health, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Joel Bazira
- Department of Pediatrics and Child Health, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Claudio Fronterre
- Lancaster Medical School, Lancaster University, Lancaster, United Kingdom
| | - Cornelia Hagmann
- Neonatology, University Children's Hospital Zurich, Zurich, Switzerland
| | - Abhaya V Kulkarni
- Department of Surgery, Hospital for Sick Children, University of Toronto, Toronto, Canada
| | - M Senthil Kumar
- Harvard T.H. Chan School of Public Health, Dana Farber Cancer Institute, Boston, Massachusetts, USA
| | | | | | - Sarah U Morton
- Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Mercedeh Movassagh
- 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
| | - John Mugamba
- CURE Children's Hospital of Uganda, Mbale, Uganda
| | | | | | | | - Peter Olupot-Olupot
- Mbale Clinical Research Institute, Mbale Regional Referral Hospital, Mbale, Uganda
- Department of Public Health, Busitema University, Busitema, Uganda
| | - Justin Onen
- CURE Children's Hospital of Uganda, Mbale, Uganda
| | - Kathryn Sheldon
- Department of Pediatrics, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Jasmine Smith
- Department of Pediatrics, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Paddy Ssentongo
- Department of Pediatrics, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | | | - Benjamin Warf
- Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | | | - Lijun Zhang
- Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Julius Kiwanuka
- Department of Pediatrics and Child Health, Mbarara University of Science and Technology, Mbarara, Uganda
| | | | - James R Broach
- Department of Pediatrics, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Steven J Schiff
- Department of Neurosurgery, Yale University School of Medicine, New Haven, Connecticut, USA
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Lu J, Sha Y, Gao M, Shi W, Lin X, Li K, Bao Q, Feng C. Identification and characterization of a novel aminoglycoside O-nucleotidyltransferase ANT(6)-If from Paenibacillus thiaminolyticus PATH554. Front Microbiol 2023; 14:1184349. [PMID: 37455719 PMCID: PMC10343464 DOI: 10.3389/fmicb.2023.1184349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Accepted: 06/07/2023] [Indexed: 07/18/2023] Open
Abstract
Background Paenibacillus thiaminolyticus, a species of genus Paenibacillus of the family Paenibacillaceae, exists widely in environments and habitats in various plants and worms, and occasionally causes human infections. This work aimed to characterize the function of a novel aminoglycoside O-nucleotidyltransferase resistance gene, designated ant(6)-If, from a P. thiaminolyticus strain PATH554. Methods Molecular cloning, antimicrobial susceptibility testing, enzyme expression and purification, and kinetic analysis were used to validate the function of the novel gene. Whole-genome sequencing and comparative genomic analysis were performed to investigate the phylogenetic relationship of ANT(6)-If and other aminoglycoside O-nucleotidyltransferases, and the synteny of ant(6)-If related sequences. Results The recombinant with the cloned ant(6)-If gene (pMD19-ant(6)-If/DH5α) demonstrated a 128-fold increase of minimum inhibitory concentration level against streptomycin, compared with the control strains (DH5α and pMD19/DH5α). The kinetic parameter kcat/Km of ANT(6)-If for streptomycin was 9.01 × 103 M-1·s-1. Among the function-characterized resistance genes, ANT(6)-If shared the highest amino acid sequence identity of 75.35% with AadK. The ant(6)-If gene was located within a relatively conserved genomic region in the chromosome. Conclusion ant(6)-If conferred resistance to streptomycin. The study of a novel resistance gene in an unusual environmental bacterium in this work contributed to elucidating the resistance mechanisms in the microorganisms.
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Affiliation(s)
- Junwan Lu
- Medical Molecular Biology Laboratory, School of Medicine, Jinhua Polytechnic, Jinhua, China
- Key Laboratory of Medical Genetics of Zhejiang Province, Key Laboratory of Laboratory Medicine, School of Laboratory Medicine and Life Sciences, Institute of Biomedical Informatics, Ministry of Education, Wenzhou Medical University, Wenzhou, China
| | - Yuning Sha
- Key Laboratory of Medical Genetics of Zhejiang Province, Key Laboratory of Laboratory Medicine, School of Laboratory Medicine and Life Sciences, Institute of Biomedical Informatics, Ministry of Education, Wenzhou Medical University, Wenzhou, China
| | - Mengdi Gao
- Key Laboratory of Medical Genetics of Zhejiang Province, Key Laboratory of Laboratory Medicine, School of Laboratory Medicine and Life Sciences, Institute of Biomedical Informatics, Ministry of Education, Wenzhou Medical University, Wenzhou, China
| | - Weina Shi
- Key Laboratory of Medical Genetics of Zhejiang Province, Key Laboratory of Laboratory Medicine, School of Laboratory Medicine and Life Sciences, Institute of Biomedical Informatics, Ministry of Education, Wenzhou Medical University, Wenzhou, China
| | - Xi Lin
- Key Laboratory of Medical Genetics of Zhejiang Province, Key Laboratory of Laboratory Medicine, School of Laboratory Medicine and Life Sciences, Institute of Biomedical Informatics, Ministry of Education, Wenzhou Medical University, Wenzhou, China
| | - Kewei Li
- Key Laboratory of Medical Genetics of Zhejiang Province, Key Laboratory of Laboratory Medicine, School of Laboratory Medicine and Life Sciences, Institute of Biomedical Informatics, Ministry of Education, Wenzhou Medical University, Wenzhou, China
| | - Qiyu Bao
- Medical Molecular Biology Laboratory, School of Medicine, Jinhua Polytechnic, Jinhua, China
- Key Laboratory of Medical Genetics of Zhejiang Province, Key Laboratory of Laboratory Medicine, School of Laboratory Medicine and Life Sciences, Institute of Biomedical Informatics, Ministry of Education, Wenzhou Medical University, Wenzhou, China
| | - Chunlin Feng
- Medical Molecular Biology Laboratory, School of Medicine, Jinhua Polytechnic, Jinhua, China
- Key Laboratory of Medical Genetics of Zhejiang Province, Key Laboratory of Laboratory Medicine, School of Laboratory Medicine and Life Sciences, Institute of Biomedical Informatics, Ministry of Education, Wenzhou Medical University, Wenzhou, China
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Smallcomb LS, Dixon TC, Azad KN, Marvin WE. A rare case of neonatal meningoencephalitis from Paenibacillus thiaminolyticus. Access Microbiol 2022; 4:acmi000430. [PMID: 36644737 PMCID: PMC9836056 DOI: 10.1099/acmi.0.000430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 11/22/2022] [Indexed: 12/12/2022] Open
Abstract
Paenibacillus infections can be life threatening and are being reported with increasing incidence. There are only a few case reports of infections and are mainly described in patients who are immunocompromised, injection drug users, or those with prosthetic devices. Due to improved testing and identification, it appears that these infections may not be as rare as once perceived. We present a case of a 16-day-old term neonate who presented with status epilepticus and was found to have Paenibacillus thiaminolyticus meningoencephalitis. The patient was successfully treated with a combination of ampicillin and ceftazidime then meropenem. To our knowledge, this is the first reported case of an infant in the United States who survived this serious invasive infection. We also present an option for therapy given the difficulty treating invasive intracranial infections.
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Affiliation(s)
- Laura S. Smallcomb
- PGY-4 Department of Medicine and Pediatrics, Medical University of South Carolina, Charleston, SC, SJCH, 10 McClennan Banks Dr. MSC 915. Charleston, SC 29425, USA,*Correspondence: Laura S. Smallcomb, ;
| | - Terry C. Dixon
- Department of Pediatrics. Division of Pediatric Infectious Diseases, Medical University of South Carolina, Charleston, SC, 96 Jonathan Lucas St., Rm 428C CSB. Charleston, SC 29425, USA
| | - Kamran N. Azad
- Quest Diagnostics, 33608 Ortega Highway, San Juan Capistrano, CA 92675, USA
| | - Whitney E. Marvin
- Department of Pediatrics, Division of Pediatric Critical Care. Medical University of South Carolina, Charleston, SC, 125 Doughty Street MSC 917. Charleston, SC 29425, USA
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Rampacci E, Sforna M, Dentini A, Di Matteo I, Lidano P, Capucci C, Passamonti F. Paenibacillus amylolyticus osteomyelitis in a Poodle dog: case report and literature review. J Vet Diagn Invest 2022; 34:703-708. [DOI: 10.1177/10406387221100996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
Paenibacilli are gram-variable, endospore-forming bacteria that occupy various ecologic niches. These microorganisms have been known to infect humans occasionally at various anatomic sites. However, in humans, as well as in other vertebrate animals, the relationship between disease and isolation of Paenibacillus spp. remains poorly understood. We report here a case of infection in an adult Poodle dog. The animal had nodules in the lungs and multifocal osteolytic expansile bone lesions. From bone, Paenibacillus amylolyticus was recovered by culture and identified by MALDI-TOF mass spectroscopy and 16S rDNA sequencing; pyogranulomatous inflammation was observed in lung and bone specimens. The microorganism was resistant to clindamycin and imipenem. Four-month treatment with amoxicillin–clavulanate resulted in clinical resolution of disease in this dog. Nevertheless, therapy for more prolonged periods should be considered because recurrent infections can occur as a result of the transition of Paenibacillus spores to vegetative cells. Disease caused by a Paenibacillus species has not been reported previously in dogs, to our knowledge.
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Affiliation(s)
- Elisa Rampacci
- Department of Veterinary Medicine, University of Perugia, Perugia, Italy
| | - Monica Sforna
- Department of Veterinary Medicine, University of Perugia, Perugia, Italy
| | | | | | - Plinio Lidano
- Ambulatorio Veterinario Il Borgo, Sansepolcro, Arezzo, Italy
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