First case series of emerging Rickettsial neonatal sepsis identified by polymerase chain reaction-based deoxyribonucleic acid sequencing.
OBJECTIVE
To detect and identify the aetiological agent in the peripheral blood from the cases of neonatal sepsis.


METHODS
Four neonates from geographically different regions of South India presented with signs of neonatal sepsis and all the routine clinical and laboratory investigations were performed. Blood culture by Bac T Alert 3D was negative. To establish the aetiology, polymerase chain reaction (PCR) for eubacterial genome and subsequent amplification with Gram positive and Gram negative primers were performed followed by deoxyribonucleic acid (DNA) sequencing.


RESULTS
PCR for the detection of eubacterial genome was positive in all the four neonates and further amplification with designed Gram positive and Gram negative primers revealed the presence of Gram negative bacteria. The amplicons were identified as Orientia tsutsugamushi in three neonates and Coxiella burnetti in the other neonate. Multalin analysis was done to further characterise the strain variation among the three strains.


CONCLUSIONS
PCR-based DNA sequencing is a rapid and reliable diagnostic tool to identify the aetiological agents of neonatal sepsis. This is the first case series of emerging Rickettsial neonatal sepsis in India .
Larsen and Toubro Microbiology Research Centre, Kamal Nayan Bajaj Research Centre, Vision Research Foundation, Nungambakkam, Chennai, Tamil Nadu, India.
P
P
Aarthi
R
R
Bagyalakshmi
K R
KR
Mohan
M
M
Krishna
M
M
Nitin
H N
HN
Madhavan
S
S
Kalyani
D000328:Adult; D021821:Communicable Diseases, Emerging / Q000175:diagnosis / Q000382:microbiology / Q000473:pathology; D016997:Coxiella burnetii / Q000302:isolation & purification*; D005260:Female; D006801:Humans; D007194:India; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012285:Orientia tsutsugamushi / Q000302:isolation & purification*; D016133:Polymerase Chain Reaction / Q000379:methods*; D011247:Pregnancy; D012288:Rickettsiaceae Infections / Q000175:diagnosis* / Q000382:microbiology / Q000473:pathology; D018805:Sepsis / Q000175:diagnosis* / Q000382:microbiology / Q000473:pathology; D017422:Sequence Analysis, DNA / Q000379:methods*; D055815:Young Adult