Pediatr Infect Vaccine.  2016 Dec;23(3):172-179. 10.14776/piv.2016.23.3.172.

Molecular Epidemiology of Bacillus cereus in a Pediatric Cancer Center

Affiliations
  • 1Department of Pediatrics, Myongji Hospital, Seonam University College of Medicine, Goyang, Korea.
  • 2Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. yaejeankim@skku.edu
  • 3Center for Clinical Research, Samsung Biomedical Research Institute, Seoul, Korea.
  • 4Department of Pediatrics, Good Gang-An Hospital, Busan, Korea.
  • 5Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Abstract

PURPOSE
Bacillus cereus has been reported as the cause of nosocomial infections in cancer patients. In our pediatric cancer ward, a sudden rise in the number of patients with B. cereus bacteremia was observed in 2013 to 2014. This study was performed to investigate the molecular epidemiology of increased B. cereus bacteremia cases in our center.
METHODS
Pediatric cancer patients who developed B. cereus bacteremia were identified from January 2001 to June 2014. The B. cereus bacteremia in this study was defined as a case in which at least one B. cereus identified in blood cultures, regardless of true bacteremia. Available isolates were further tested by multilocus sequence typing (MLST) analysis. A retrospective chart review was performed.
RESULTS
Nineteen patients developed B. cereus bacteremia during the study period. However, in 2013, a sudden increase in the number of patients with B. cereus bacteremia was observed. In addition, three patients developed B. cereus bacteremia within 1 week in July and the other three patients within 1 week in October, respectively, during emergency room renovation. However, MLST analysis revealed different sequence types without consistent patterns. Before 2013, five tested isolates were ST18, ST26, ST177, and ST147-like type, and ST219-like type. Isolates from 2013 were ST18, ST73, ST90, ST427, ST784, ST34-like type, and ST130-like type.
CONCLUSIONS
MLST analyses showed variable ST distribution of B. cereus isolates. Based on this study, there was no significant evidence suggesting a true outbreak caused by a single ST among patients who developed B. cereus bacteremia.

Keyword

Bacillus cereus; Disease outbreaks; Multilocus sequence typing; Pediatrics; Neoplasms

MeSH Terms

Bacillus cereus*
Bacillus*
Bacteremia
Cross Infection
Disease Outbreaks
Emergency Service, Hospital
Humans
Molecular Epidemiology*
Multilocus Sequence Typing
Pediatrics
Retrospective Studies

Figure

  • Fig. 1 Distribution of Bacillus cereus bacteremia episodes by year. Number in the bar indicates each bacteremia episode. No. 5 and 14 are two episodes from the same patient.

  • Fig. 2 Phylogenetic tree of 15 tested isolates. Numbers in parentheses indicate each isolate ID. Isolates from episodes 1, 2, 3, 4, and 16: not available. The scale at the bottom represents genetic distances in nucleotide substitutions per site.


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