Affiliations: Perinatal Center, Department of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden | Department of Pediatrics, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, PR China | Division of Infectious Diseases, Department of Medicine, Children's Hospital, Boston, MA, USA | Human Biology & Translational Medicine, Harvard Medical School, Boston, MA, USA
Note:  Correspondence to: Ofer Levy, MD, PhD, Children's Hospital Boston, 300 Longwood Avenue, Boston, MA 02115, USA. Tel.: +1 617 919 2904; E-mail: [email protected]
Abstract: Bacterial infection induces inflammatory responses that can be protective but may also lead to host tissue injury. Indeed, in animal models direct introduction of bacteria to the central nervous system induces inflammation, apoptosis and neurologic sequelae. Preterm newborns are at particular risk of neurologic injury. The most common cause of bloodstream infection (bacteremia) in preterm newborns are coagulase-negative staphylococci (CONS), especially Staphylococcus epidermidis (SE). SE expresses multiple Toll-like receptor 2 (TLR2) agonists and systemic TLR2 activation can result in brain injury in newborn mice. Herein we summarize evidence based on epidemiologic and immunologic studies that raise the hypothesis that SE infection and associated systemic inflammation may contribute to neonatal brain injury.
Keywords: Newborn, neonate, white matter, cerebral palsy, inflammation