The molecular characterisation of bacteria associated with neonatal necrotising enterocolitis and sepsis which were isolated from hospitals in Bogotá, Colombia
Keywords:Necrotising enterocolitis (NNE), sepsis, molecular characterisation, multilocus sequence typing (MLST)
Background: The identification and molecular characterisation of bacteria associated with neonatal necrotising enterocolitis (NNE) and sepsis is very important in clarifying the role such bacteria play in the development of this disease.
Methods: The present multicentre study was aimed at characterising bacteria isolated from haemocultures obtained from 20 neonates suffering NNE by using traditional and molecular methodologies (16 S rRNA subunit sequencing and multilocus sequence typing - MLST).
Results: NNE incidence in hospitals in Bogotá was also estimated, finding rates similar to and higher than those reported in the literature (1 to 3 cases of NNE per 1,000 live-births). Staphylococcus epidermidis ST2, ST81, and ST126 sequence types were identified by using these two molecular techniques; the Escherichia coli ST394 sequence type was also identified. Species could not be identified for the Pantoea agglomerans isolate due to the high degree of intra-species identity. Interestingly, the bacterial isolates from the two neonates who died were classified in the same sequence type (i.e. S. epidermidis ST81), even though they came from different hospitals.
Conclusion: Such molecular techniques allow characterising bacterial pathogen populations occurring in one or more hospitals in a particular city or determined geographical area and support taking more specific preventative measures directed against such particular clones.
Pammi M, De Plaen IG, Maeshwari A. Recent advances in necrotizing enterocolitis research strategies for implementation in clinical practice. Clin Perinatol 2020; 47(2): 383-397.
Hackam DJ, Sodhi CP. Bench to bedside-new insights into the pathogenesis of necrotising enterocolitis. Nature reviews gastroenterology and hepatology. 2022; 19: 468-479
Wang Y, Hoenig JD, Malin KJ, et al. 16S rRNA gene–based analysis of fecal microbiota from preterm infants with and without necrotising enterocolitis. ISME J 2009; 3: 944-54.
Relman DA. The search for unrecognized pathogens. Science. 1999; 284: 1308–1310.
Cooper JE and Feil EJ. Multilocus sequence typing – what is resolved? Trends Microbiol. 2004; 12(8):373-7.
Spratt B.G. Multilocus sequence typing: molecular typing of bacterial pathogens in an era of rapid DNA sequencing and the Internet. Curr Opin Microbiol 1999; (2):312-316.
Foxman B, Zhang L, Koopman JS, Manning SD, Marrs C.F. Choosing an appropriate bacterial typing technique for epidemiologic Studies. Epidemiol Perspect Innov. 2005; 2:10.
Bell MJ, Ternberg JL, Feigin RD, Keating JP, Marshall R, Barton L, et al. Neonatal necrotizing enterocolitis. Therapeutic decisions based upon clinical staging. Ann Surg. 1978;187(1):1–7
Lu JJ, Perng CL, Lee SY, Wan CC. Use of PCR with universal primers and restriction endonuclease digestions for detection and identification of common bacterial pathogens in cerebrospinal fluid. J Clin Microbiol. 2000; 38 (6): 2076–2080.
Fundora JB, Guha P, Shores CR, Pammi M and Maheshwari A. Intestinal dysbiosis and necrotizing enterocolitis: Assessment for causality using Bradford-Hill criterio. Pediatric Research 2020; 87: 235-248.
Carl MA, Ndao IM, Springman AC, Manning SD, Johnson JR, Johnston BD, et al. Sepsis from the gut: The enteric habitat of bacteria that cause late-onset neonatal bloodstream infections. Clin Infect Dis 2014; 58(9): 1211-1218.
Okeke IN, Wallace-Gadsden F, Simons HR, Mattews N, Labar AS, Hwan J., et al. Multi-Locus Sequence Typing of Enteroaggregative Escherichia coli Isolates from Nigerian Children Uncovers Multiple Lineages. PLoS One. 2010; 5(11): e14093
Lemme-Dumit JM, Song Y, Lwin HW, Hernandez-Chavez C, Sundararajan S, Viscardi RM, et al. Altered gut microbiome and fecal immune phenotype in early preterm infants with leaky gut. Front Immunol. 2022; 13: 815046.
Scheifele DW, Bjornson GL, Dyer RA, Dimmick, JE. Delta-like toxin produced by coagulase-negative staphylococci is associated with neonatal necrotizing enterocolitis. Infect Imm, Sept 1987; 5(9): 2268-2273.
Joubert IA, Otto M, Strunk T and Currie AJ. Look who’s talking: host and pathogen drivers of Staphylococcus epidermidis virulence in neonatal sepsis. Int J Mol Sci. 2022; 23(2): 860
Soeorg H, Huik K, Parm E, Ilmoja ML, Metsvaht T and Lutsar I. Molecular epidemiology of Staphylococcus epidermidis in neonatal intensive care units. Acta Pathologica, Microbiologica et Immunologica Scandinavica. 2017; 125(1):63-73.
Miragaia M, Thomas JC, Couto I, Enright MC, Lencastre H. Inferring a population structure for Staphylococcus epidermidis from multilocus sequence typing data. J Bacteriol. 2007; 189 (6): 2540–2552.
Both A, Huang J, Qi M, Lausman C, Weiselberg S, Buttner H, et al. Distinct clonal lineages and within-host diversification shape invasive Staphylococcus epidermidis populations. PLoS Pathog. 2021; 17(2): e1009304
Tarracchini C, Milani C, Longhi G, Fontana F, Mancabelli L, Pintus R. et al. Unraveling the microbiome of necrotizing enterocolitis: insights in novel microbial and metabolomic biomarkers. Microbiol Spectr. 2021; 9(2): e01176-21.
Grishin A, Papillon S, Bell B, Wang J and Ford HR. The role of the intestinal microbiota in the pathogenesis of necrotizing enterocolitis. Semin Pediatr Surg. 2013; 22(2): 69-75.
Mani S, Muasevic A and Adler JR. Pantoea infections in the neonatal intensive care unit. 2021. Cureus; 13(2): e13103.
Yehia N, Hadeel N, Reda S, Lila A, Nagaraja P. Pantoea agglomerans bloodstream infection in preterm neonates. Med Princ Pract 2008; 17: 500–503.
Delétoile A, Decré D, Courant S, Passet V, Audo J, Grimont P, Arlet G, Brisse S. Phylogeny and identification of Pantoea species and typing of Pantoea agglomerans strains by multilocus gene sequencing. J Clin Microbiol. 2009; 47(2): 300-10.
How to Cite
Copyright (c) 2023 Afghanistan Journal of Infectious Diseases
This work is licensed under a Creative Commons Attribution 4.0 International License.