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

J Trop Pediatr. 2022 Oct 6;68(6):fmac085. doi: 10.1093/tropej/fmac085.

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%).

Keywords: Enterobacter agglomerans; blood; infections; neonates.

Plain language summary

Enterobacter agglomerans formerly Erwina herbicola but now called Pantonea agglomerans is a gram-negative organism that is found everywhere in our environment. It rarely causes a mild infection in humans, which is either local or generalized. Severe disease has been reported in babies and the elderly because of their low immunity and/or comorbid condition. The study aimed to report this rare condition in our neonatal unit. The study was conducted in the baby unit of Ahmadu Bello University Teaching Hospital in Zaria over 10 months. Any baby with symptoms/signs of infection was enrolled in the study and had their blood samples taken to look for the presence of infection. Of the 248 babies who were recruited, 94 had bacteria isolated from their blood out of whom 8 were due to E. agglomerans. All our babies came from the community as such source of infection could not be determined. Most had non-specific presentation fever, poor suck and jaundice and none had comorbidity or complicated procedures. The organism is generally sensitive to most antibiotics tested. All but one of the babies survived. Our study found E. agglomerans infection to be mild with a good prognosis.

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Bacterial Infections* / drug therapy
  • Ciprofloxacin
  • Community-Acquired Infections* / diagnosis
  • Community-Acquired Infections* / drug therapy
  • Enterobacter
  • Gentamicins
  • Humans
  • Infant, Newborn
  • Pantoea*
  • Procalcitonin

Substances

  • Anti-Bacterial Agents
  • Gentamicins
  • Procalcitonin
  • Ciprofloxacin