Enterobacter agglomerans, an uncommon cause of community-acquired bacterial infection in neonates

Abstract

Enterobacter agglomerans formerly termed Erwina herbicola but now called Pantonea agglomerans is a ubiquitous gram-negative bacterium that rarely causes mild and opportunistic infection in humans. Sources of infection are myriad causing both local and systemic disease across all systems of the body. Infection is often fulminant and fatal in neonates. We aim to report another facet of the infection as seen in our centre. Of the 248 neonates recruited into the study, 94 had bacteria isolated from their blood, eight (8.5%) of whom had E. agglomerans sepsis. Infection was acquired from the community though its source could not be determined. The clinical features were non-specific running a mild course. Toxic granulation, elevated immature polymorph count and procalcitonin level was found in 50% and 75% of the neonates. Isolate was sensitive to most tested antibiotics, showing 100% sensitivity to gentamicin and ciprofloxacin and the survival rate was excellent (87.5%).

Bloodstream Infections by Pantoea Species: Clinical and Microbiological Findings from a Retrospective Study, Italy, 2018–2023

“…Comparing the main reported series, Pantoea species bloodstream infections are mostly healthcare-acquired [11,37,58,59], being involved in nosocomial outbreaks [18][19][20][21]49,57,61] or otherwise in neonatal, mostly late-onset, sepsis [15][16][17]62]. This finding is consistent with data from our study also showing no community acquisition among pediatric patients, with some cases having been reported, however [14,79].…”

“…Among adults, extended-spectrum cephalosporins are common treatment options, but resistance rates to these antimicrobials ranged from 0% [60] to 37.7% [11]. Resistance to amoxicillin/clavulanic acid, gentamicin, and fosfomycin was reported sporadically [16,37,79]. Our study highlighted an overall resistance rate to piperacillin/tazobactam of 15.8%, warranting ongoing and vigilant monitoring.…”

Recent Records on Bacterial Opportunistic Infections via the Dietary Route

“…The reports described in this review are summarized in Table S1 [ 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 ], where the bacterial groups involved in the illnesses are reported in alphabetical order along where the type of ...…”

“…It causes local or systemic opportunistic infection that can be severe in newborns and in the elderly. Neonatal cases and outbreaks were often nosocomial, with the main risk factors including an immunocompromised state due to an immature immune system and comorbidities [ 30 ]. Infant formula can be a food source of infection [ 92 ].…”

“…The mortality rate was 12.5%. The source of infection could not be infant formula, since all the babies were breastfed, so it was suspected that the hands of family members and the household environment served as the sources [ 30 ].…”