HumanPaenibacillusInfections: A Systematic Review with Comparison of Adult and Infant Cases

Abstract

AbstractNeonatal infections due toPaenibacillus specieshave increasingly been reported over the last few years. We performed a structured literature review of humanPaenibacillusinfections in infants and adults to compare the epidemiology of infections between these distinct patient populations. Thirty-nine reports describing 176 infections met our inclusion criteria and were included. There were 37Paenibacillusinfections occurring in adults caused by 23 species. The clinical presentations of infections were quite variable. In contrast, infections in infants were caused by only 3 species:P. thiaminolyticus(112/139, 80%),P. alvei(2/139, 1%) andP. dendritiformis(2/139, 1%). All of the infants withPaenibacillusinfection presented with a sepsis syndrome or meningitis, often complicated by extensive cerebral destruction and hydrocephalus. Outcomes were commonly poor with 17% (24/139) mortality. Cystic encephalomalacia due to brain destruction was common in both Ugandan and American cases and 92/139 (66%) required surgical management of hydrocephalus following their infection.Paenibacillusinfections are likely underappreciated in infants and effective treatments are urgently needed.