Maternal and neonatal IgG against Klebsiella pneumoniae are associated with broad protection from neonatal sepsis: a case-control study of hospitalized neonates in Botswana

作者：Siqi Linsey Zhang, Carolyn McGann, Tereza Duranova, Jonathan Strysko, Andrew P. Steenhoff, Alemayehu Mekonnen Gezmu, Britt Nakstad, Tonya Arscott‐Mills, One Bayani, Banno Moorad, Nametso Tlhako, Melissa Richard‐Greenblatt, Paul J. Planet, Susan Coffin, Michael A. Silverman · 发表于：medRxiv · 年份：2024 · DOI：10.1101/2024.05.28.24308042 · 被引用次数：3 · 研究领域：Neonatal and Maternal Infections、Sepsis Diagnosis and Treatment、Pneumonia and Respiratory Infections

ABSTRACT Sepsis is the leading postnatal cause of neonatal mortality worldwide. Globally Klebsiella pneumoniae is the leading cause of sepsis in hospitalized neonates. This study reports development and evaluation of ELISA for anti- Klebsiella IgG using dried blood spot samples and evaluates the association of anti- Klebsiella IgG (anti-Kleb IgG) antibodies in maternal and neonatal samples and the risk of neonatal sepsis. Neonates and their mothers were enrolled at 0-96 hours of life in the neonatal unit of a tertiary referral hospital in Gaborone, Botswana and followed until death or discharge to assess for episodes of blood culture-confirmed neonatal sepsis. Neonates with sepsis had significantly lower levels of Kleb- IgG compared to neonates who did not develop sepsis (Mann-Whitney U, p=0.012). Similarly, samples from mothers of neonates who developed sepsis tended to have less Kleb- IgG compared to mothers of controls (p=0.06). The inverse correlation between Kleb-IgG levels and all-cause bacteremia suggests that maternal Kleb- IgG is broadly protective through cross-reactivity with common bacterial epitopes. These data support the continued use of immunoglobulin assays using DBS samples to explore the role of passive immunity on neonatal sepsis risk and reaffirm the critical need for research supporting the development of maternal vaccines for neonatal sepsis.