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Published on: October 2, 2018
Meningitis and brain abscess formation caused by Cronobacter malonaticus sequence type 440 in a full-term neonate
Shogo Otake1, Yumiko Okada2, Stephen James Forsythe3
1Division of Infectious Disease, Department of Pediatrics, Hyogo Prefectural Kobe Children's Hospital, Japan.
Abstract:
Cronobacter spp. cause serious diseases, such as necrotizing enterocolitis, bacteremia, and meningitis in neonates and infants. Most Cronobacter-associated meningitis is reportedly due to C. sakazakii and the majority of infections caused by C. malonaticus occur in adults and are less severe. We report the case of meningitis and brain abscess caused by C. malonaticus Sequence Type (ST) 440 in a healthy full-term neonate. We should consider the possibility that full-term neonates may develop meningitis due to C. malonaticus and treat appropriately because its mortality rate is very high, and survivors are usually left with severe neurologic impairment. In addition, C. malonaticus ST440 may have virulence factors that cause neonatal meningitis akin to the previous report of meningitic ST307 strain.
Insights
Cronobacter malonaticus can cause severe meningitis and brain abscesses in healthy neonates. This highlights the need for prompt diagnosis and treatment in infants, as outcomes can be devastating.
Area of Science:
- Microbiology
- Neonatal Infectious Diseases
- Bacterial Pathogenesis
Background:
- Cronobacter spp. are known pathogens causing severe infections like meningitis in neonates and infants.
- Cronobacter sakazakii is the most common cause of Cronobacter-associated meningitis.
- Cronobacter malonaticus infections typically occur in adults and are less severe.
Observation:
- A case of meningitis and brain abscess caused by Cronobacter malonaticus Sequence Type (ST) 440 in a healthy full-term neonate is presented.
- This case challenges the common understanding of C. malonaticus as primarily an adult pathogen causing milder infections.
Findings:
- Cronobacter malonaticus ST 440 demonstrated significant virulence, leading to severe neonatal meningitis and brain abscess.
- The high mortality rate and potential for severe neurologic sequelae in survivors underscore the pathogenicity of this strain in neonates.
Implications:
- Neonatal meningitis due to Cronobacter malonaticus should be considered in clinical settings, even in healthy full-term infants.
- Prompt and appropriate treatment is crucial for improving outcomes in neonates with C. malonaticus meningitis.
- Further research into the virulence factors of C. malonaticus ST 440 is warranted to understand its pathogenicity in neonatal meningitis.
