A Systematic Review of Human Paenibacillus Infections and Comparison of Adult and Pediatric Cases
Danielle Smith1, Kristen Bastug2, Kathy Burgoine3
1From the Department of Pediatrics, Penn State College of Medicine, Hershey, Pennsylvania.
Insights
Neonatal Paenibacillus infections often lead to severe brain damage and death in infants, primarily caused by Paenibacillus thiaminolyticus. Adult Paenibacillus infections are rare and typically less severe.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Pediatric Neurology
Background:
- Neonatal infections caused by Paenibacillus species are a growing concern.
- Previous research has not extensively compared Paenibacillus infections in infants versus adults.
Purpose of the Study:
- To compare the epidemiology of human Paenibacillus infections in pediatric and adult patients.
- To characterize the clinical presentation and outcomes of Paenibacillus infections across different age groups.
Main Methods:
- A structured literature review was conducted.
- Data from 40 reports (177 infections) were analyzed, with two additional cases included.
- Epidemiological and clinical data were compared between infant and adult patient populations.
Main Results:
- Infections in infants were predominantly caused by Paenibacillus thiaminolyticus (79%).
- Infant infections commonly presented as sepsis or meningitis, frequently leading to cerebral destruction, hydrocephalus, and high mortality (17%).
- Adult infections involved a wider range of Paenibacillus species (23), were sporadic, and rarely involved the central nervous system with low mortality.
Conclusions:
- Paenibacillus species can cause a distinct, severe syndrome in infants, characterized by brain abscesses, hydrocephalus, and often fatal outcomes.
- In contrast, adult Paenibacillus infections are infrequent, generally less severe, and seldom affect the central nervous system.
Background:
Neonatal infections due to Paenibacillus species have increasingly been reported over the last few years.
Methods:
We performed a structured literature review of human Paenibacillus infections in pediatric and adult patients to compare the epidemiology of infections between these distinct patient populations.
Results:
Forty reports describing 177 infections were included. Two additional cases were brought to our attention by colleagues. There were 38 Paenibacillus infections occurring in adults caused by 23 species. The clinical presentations of infections were quite variable. In contrast, infections in infants were caused primarily by Paenibacillus thiaminolyticus (112/141, 79%). All the infants with Paenibacillus infection presented with sepsis syndrome or meningitis, often complicated by extensive cerebral destruction and hydrocephalus. Outcomes were commonly poor with 17% (24/141) mortality. Cystic encephalomalacia due to brain destruction was common in both Ugandan and American infant cases and 92/141 (65%) required surgical management of hydrocephalus following their infection.
Conclusions:
Paenibacillus species seem to cause a clinical syndrome in infants characterized by brain abscesses, hydrocephalus and death. This contrasts with infection in adults, which is sporadic with only rare involvement of the central nervous system and very few deaths.
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