title: Association of bacteria with hydrocephalus in Ugandan infants.
abstract: OBJECTIVE
  Infantile hydrocephalus in East Africa is predominantly postinfectious. The microbial origins remain elusive, since most patients present with postinfectious hydrocephalus after antecedent neonatal sepsis (NS) has resolved.
  
  
  METHODS
  To characterize this syndrome in Ugandan infants, the authors used polymerase chain reaction targeting bacterial 16S ribosomal DNA from CSF to determine if bacterial residua from recent infections were detectable. Bacteria were identified based on the relationship of genetic sequences obtained with reference bacteria in public databases. The authors evaluated samples from patients presenting during dry and rainy seasons and performed environmental sampling in the villages of patients.
  
  
  RESULTS
  Bacterial DNA was recovered from 94% of patients. Gram-negative bacteria in the phylum Proteobacteria were the most commonly detected. Within this phylum, Gammaproteobacteria dominated in patients presenting after infections during the rainy season, and Betaproteobacteria was most common following infections during the dry season. Acinetobacter species were identified in the majority of patients admitted after rainy season infection.
  
  
  CONCLUSIONS
  Postinfectious hydrocephalus in Ugandan infants appears associated with predominantly enteric gram-negative bacteria. These findings highlight the need for linking these cases with antecedent NS to develop more effective treatment and prevention strategies.
authors.affiliation: Department of Veterinary and Biomedical Sciences, The Pennsylvania State University, University Park, PA, USA.
authors.forename: Lingling
authors.initials: L
authors.lastname: Li
authors.forename: Abinash
authors.initials: A
authors.lastname: Padhi
authors.forename: Sylvia L
authors.initials: SL
authors.lastname: Ranjeva
authors.forename: Sarah C
authors.initials: SC
authors.lastname: Donaldson
authors.forename: Benjamin C
authors.initials: BC
authors.lastname: Warf
authors.forename: John
authors.initials: J
authors.lastname: Mugamba
authors.forename: Derek
authors.initials: D
authors.lastname: Johnson
authors.forename: Zephania
authors.initials: Z
authors.lastname: Opio
authors.forename: Bhushan
authors.initials: B
authors.lastname: Jayarao
authors.forename: Vivek
authors.initials: V
authors.lastname: Kapur
authors.forename: Mary
authors.initials: M
authors.lastname: Poss
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Schiff
mesh_terms: D015331:Cohort Studies; D004269:DNA, Bacterial / Q000134:cerebrospinal fluid*; D005260:Female; D006090:Gram-Negative Bacteria / Q000235:genetics / Q000302:isolation & purification*; D016905:Gram-Negative Bacterial Infections / Q000150:complications* / Q000382:microbiology; D006801:Humans; D006849:Hydrocephalus / Q000134:cerebrospinal fluid / Q000453:epidemiology* / Q000382:microbiology*; D007223:Infant; D008297:Male; D016133:Polymerase Chain Reaction; D020560:Proteobacteria / Q000302:isolation & purification; D012336:RNA, Ribosomal, 16S / Q000134:cerebrospinal fluid*; D012621:Seasons; D014454:Uganda / Q000453:epidemiology
chemical_list: D004269:DNA, Bacterial; D012336:RNA, Ribosomal, 16S