Abstract
During March 13–June 23, 2018, anthrax-like cutaneous lesions attributed to the Bacillus cereus group of organisms developed in 12 newborns in India. We traced the source of infection to the healthcare kits used for newborn care. We used multilocus sequence typing to characterize the 19 selected strains from various sources in hospital settings, including the healthcare kits. This analysis revealed the existence of a genetically diverse population comprising mostly new sequence types. Phylogenetic analysis clustered most strains into the previously defined clade I, composed primarily of pathogenic bacilli. We suggest that the synergistic interaction of nonhemolytic enterotoxin and sphingomyelinase might have a role in the development of cutaneous lesions. The infection was controlled by removing the healthcare kits and by implementing an ideal housekeeping program. All the newborns recovered after treatment with ciprofloxacin and amikacin.
Highlights
During March 13–June 23, 2018, anthrax-like cutaneous lesions attributed to the Bacillus cereus group of organisms developed in 12 newborns in India
The B. cereus multilocus sequence typing (MLST) database clusters the available 1,795 sequence type (ST) into 10 major clonal complexes (CCs); a CC is a group of STs defined by goeBURST using the stringent group definition of single-locus variant level
With a less stringent group definition of double-locus variant (DLV, sharing at least 5/7 alleles) or triple-locus variant (TLV, sharing at least 4/7 alleles) level, all of the STs in a goeBURST group cannot be considered as members of a single CC and referred to as BURST groups (BGs) in our study
Summary
During March 13–June 23, 2018, anthrax-like cutaneous lesions attributed to the Bacillus cereus group of organisms developed in 12 newborns in India. We used multilocus sequence typing to characterize the 19 selected strains from various sources in hospital settings, including the healthcare kits. This analysis revealed the existence of a genetically diverse population comprising mostly new sequence types. B. cereus is well-known as a foodborne pathogen In recent years, this bacterium was reported to cause several systemic and local nongastrointestinal infections in immunocompromised and immunocompetent persons [4,5]. We describe a cluster of 12 cases of severe anthrax-like cutaneous infections in otherwise healthy newborns attributed to the B. cereus group
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