Case Report: A Domestic Sponge Brush Used to Clean a Milk Feeding Bottle: The Source of Neonatal Meningitis Caused by Pseudomonas aeruginosa

Abstract

Pseudomonas aeruginosa is a relatively rare cause of neonatal meningitis, and most patients have serious underlying diseases, prematurity, immunodeficiency, or anatomical abnormalities. We report the case of a 7-day-old girl with meningitis caused by P. aeruginosa. She was born full-term and had no immunodeficiency or anatomical abnormalities as far as our investigation ascertained. Through the use of anti-Pseudomonas antibiotics, she recovered without any complications other than a slight hearing disability revealed by audiology testing. P. aeruginosa was also isolated from a domestic sponge brush used to clean her milk bottle. Physicians should consider P. aeruginosa as a possible pathogen of neonatal meningitis even in full-term infants with no immunodeficiency or anatomical abnormalities. Physicians should give advice concerning appropriate hygiene practices to be applied to the neonate's environment.

Keywords: Pseudomonas aeruginosa; environment; infection prevention; neonatal meningitis; sponge brush.

Figure 1

Clinical time course of the patient.

Figure 2

Agarose gel electrophoresis patterns of the PCR-based open reading frame typing (POT) using the Cica Geneus Pseudo POT KIT. PCR of reaction mixtures 1 and 2 was carried out for strain 1 and 2. Lane 1: strain 1 obtained from the patient's cerebrospinal fluid. Lane 2: strain 2 obtained from a cleaning sponge brush. The sizes of the bands in the M lane are 600, 500, 450, 400, 350, 300, 250, 200, 150, and 100 bp (from the top). PC, positive control; NC, negative control, used as an in-house ladder marker for detection PCR of Pseudomonas aeruginosa. Lines 1 and 2 showed the same band patterns, and the POT numbers of both strain 1 and 2 were the same values. The results from POT 1 and 2 values indicated these strains did not carry a metallo-beta-lactamase, such as IMP and VIM.