Enterococcus cecorum INFECTION IN TWO CRITICALLY ILL CHILDREN AND IN TWO ADULT SEPTIC PATIENTS

Abstract

Enterococcus cecorum is mostly found as normal gut flora in farm animals, especially pigs and poultry. However, sometimes it can cause extended infections and disease in those animals, as was recently reported in Canada where it caused arthritis and osteomyelitis in chickens. Until now, only a few reports have been published on Enterococcus cecorum as a potential pathogen in humans. We have reported 4 cases of infection with this rare human pathogen. The organism was proven in 2 blood samples from adult patients with sepsis and in 2 cerebrospinal fluid (CSF) samples taken from children with external ventricular drainage (EVD) and diagnosed ventriculitis. In two cases (one child and one adult), other bacterial pathogens were also detected. The organism could not be cultivated and could only be identified with analysis of 16S rRNA gene PCR. The following molecular biomarkers were used to confirm the infection, and exclude sample contamination: white blood cell count, neutrophils, C-reactive protein (CRP), procalcitonin (PCT) and presepsin (sCD14-ST). Enterococcus cecorum was identified as a pathogen with 16S rRNA gene PCR and could have caused the infection in all patients. We also suspected the first possible human-to-human transmission of bacteria from a mother to a newborn child.