TY - JOUR
T1 - Pathogens Identified by Minimally Invasive Tissue Sampling in India and Pakistan from Preterm Neonatal Deaths
T2 - The PURPOSE Study
AU - Ghanchi, Najia Karim
AU - Ahmed, Imran
AU - Kim, Jean
AU - Harakuni, Sheetal
AU - Somannavar, Manjunath S.
AU - Zafar, Afia
AU - Tikmani, Shiyam Sunder
AU - Saleem, Sarah
AU - Goudar, Shivaprasad S.
AU - Dhaded, Sangappa M.
AU - Guruprasad, Gowdar
AU - Yogeshkumar, S.
AU - Hwang, Kay
AU - Aceituno, Anna
AU - Silver, Robert M.
AU - McClure, Elizabeth M.
AU - Goldenberg, Robert L.
N1 - Publisher Copyright:
© 2022 The Author(s). Published by Oxford University Press on behalf of Infectious Diseases Society of America.
PY - 2023/2/1
Y1 - 2023/2/1
N2 - Background: We identified pathogens found in internal organs and placentas of deceased preterm infants cared for in hospitals in India and Pakistan. Methods: Prospective, observational study conducted in delivery units and neonatal intensive care units. Tissue samples from deceased neonates obtained by minimally invasive tissue sampling and placentas were examined for 73 different pathogens using multiplex polymerase chain reaction (PCR). Results: Tissue for pathogen PCR was obtained from liver, lung, brain, blood, cerebrospinal fluid, and placentas from 377 deceased preterm infants. Between 17.6% and 34.1% of each type of tissue had at least 1 organism identified. Organism detection was highest in blood (34.1%), followed by lung (31.1%), liver (23.3%), cerebrospinal fluid (22.3%), and brain (17.6%). A total of 49.7% of the deceased infants had at least 1 organism. Acinetobacter baumannii was in 28.4% of the neonates compared with 14.6% for Klebsiella pneumoniae, 11.9% for Escherichia coli/Shigella, and 11.1% for Haemophilus influenzae. Group B streptococcus was identified in only 1.3% of the neonatal deaths. A. baumannii was rarely found in the placenta and was found more commonly in the internal organs of neonates who died later in the neonatal period. The most common organism found in placentas was Ureaplasma urealyticum in 34% of the samples, with no other organism found in >4% of samples. Conclusions: In organ samples from deceased infants in India and Pakistan, evaluated with multiplex pathogen PCR, A. baumannii was the most commonly identified organism. Group B streptococcus was rarely found. A. baumannii was rarely found in the placentas of these deceased neonates.
AB - Background: We identified pathogens found in internal organs and placentas of deceased preterm infants cared for in hospitals in India and Pakistan. Methods: Prospective, observational study conducted in delivery units and neonatal intensive care units. Tissue samples from deceased neonates obtained by minimally invasive tissue sampling and placentas were examined for 73 different pathogens using multiplex polymerase chain reaction (PCR). Results: Tissue for pathogen PCR was obtained from liver, lung, brain, blood, cerebrospinal fluid, and placentas from 377 deceased preterm infants. Between 17.6% and 34.1% of each type of tissue had at least 1 organism identified. Organism detection was highest in blood (34.1%), followed by lung (31.1%), liver (23.3%), cerebrospinal fluid (22.3%), and brain (17.6%). A total of 49.7% of the deceased infants had at least 1 organism. Acinetobacter baumannii was in 28.4% of the neonates compared with 14.6% for Klebsiella pneumoniae, 11.9% for Escherichia coli/Shigella, and 11.1% for Haemophilus influenzae. Group B streptococcus was identified in only 1.3% of the neonatal deaths. A. baumannii was rarely found in the placenta and was found more commonly in the internal organs of neonates who died later in the neonatal period. The most common organism found in placentas was Ureaplasma urealyticum in 34% of the samples, with no other organism found in >4% of samples. Conclusions: In organ samples from deceased infants in India and Pakistan, evaluated with multiplex pathogen PCR, A. baumannii was the most commonly identified organism. Group B streptococcus was rarely found. A. baumannii was rarely found in the placentas of these deceased neonates.
KW - Acinetobacter baumannii
KW - Group B Streptococcus
KW - Klebsiella pneumoniae
KW - neonatal death
KW - organ pathogen PCR
UR - http://www.scopus.com/inward/record.url?scp=85151552570&partnerID=8YFLogxK
U2 - 10.1093/cid/ciac747
DO - 10.1093/cid/ciac747
M3 - Article
C2 - 36104850
AN - SCOPUS:85151552570
SN - 1058-4838
VL - 76
SP - E1004-E1011
JO - Clinical Infectious Diseases
JF - Clinical Infectious Diseases
IS - 3
ER -