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Nosocomial outbreak of Campylobacter jejuni meningitis in newborn infants
Insights
A nosocomial outbreak revealed Campylobacter jejuni meningitis in 11 newborn infants. This serious bacterial infection, caused by a single C. jejuni strain, highlights the need to consider it in neonatal meningitis cases.
Area of Science:
- Infectious Diseases
- Neonatal Medicine
- Microbiology
Background:
- Nosocomial outbreaks pose significant risks to vulnerable patient populations, particularly neonates.
- Campylobacter jejuni is a common cause of gastroenteritis but less frequently associated with severe invasive infections like meningitis.
- Identifying the causative agent is crucial for effective treatment and outbreak control in hospital settings.
Purpose of the Study:
- To investigate a nosocomial outbreak of meningitis in newborn infants.
- To identify the specific pathogen responsible for the outbreak.
- To characterize the outbreak strain and assess treatment outcomes.
Main Methods:
- Epidemiological investigation of the outbreak.
- Biotyping, serotyping (heat-stable and heat-labile antigens), and outer-membrane-protein profiling (SDS-PAGE) for strain characterization.
- Detection of specific antibodies using enzyme-linked immunosorbent assay (ELISA) and Western blot.
- Clinical assessment and treatment monitoring.
Main Results:
- Eleven newborn infants developed meningitis during a single-strain Campylobacter jejuni outbreak.
- The outbreak strain was identified as C. jejuni biotype I, serotype LAU 7/PEN 18 (heat-stable), with a novel heat-labile antigen serotype.
- All affected infants developed specific antibodies and were treated with gentamicin and ampicillin, with most recovering well.
- One infant experienced a moderately dilated left lateral ventricle post-meningitis.
Conclusions:
- Campylobacter jejuni can cause severe nosocomial meningitis in newborn infants.
- This pathogen should be considered in the differential diagnosis of neonatal meningitis, especially in compromised hosts.
- Effective antibiotic treatment (gentamicin and ampicillin) can lead to good outcomes, though potential sequelae should be monitored.
Abstract:
In a nosocomial outbreak of Campylobacter jejuni infection 11 newborn infants (7 female, 4 male) had meningitis. The outbreak was caused by a single strain of C jejuni, as demonstrated by biotyping (biotype I), serotyping (LAU 7/PEN 18 on heat-stable antigens, a new serotype on heat-labile antigens), and the identical susceptibility pattern and outer-membrane-protein profile on sodium dodecyl sulphate/polyacrylamide gel electrophoresis. Specific antibodies against the outbreak strain (enzyme-linked immunosorbent assay and Western blot) developed in all the babies. They were treated with gentamicin and ampicillin. All but one baby, who had a moderately dilated left lateral ventricle after the meningitis, recovered well. The source of infection could not be clearly determined. Thus, C jejuni can cause serious nosocomial infection; it should be considered as a possible agent of meningitis of unknown origin, particularly in newborn infants and other compromised hosts.