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A Chryseobacterium meningosepticum Outbreak in a Neonatal Ward

Published online by Cambridge University Press:  02 January 2015

Serdal Güngör
Affiliation:
Department of Pediatrics, Medical Faculty of Inönü University, Malatya, Turkey
Metehan Özen*
Affiliation:
Department of Pediatrics, Medical Faculty of Inönü University, Malatya, Turkey
Aysehan Akinci
Affiliation:
Division of Pediatric Endocrinology, Department of Pediatrics, Medical Faculty of Inönü University, Malatya, Turkey
Riza Durmaz
Affiliation:
Department of Clinical Microbiology, Turgut Özal Research Center, Medical Faculty of Inönü University, Malatya, Turkey
*
Uran Kent, E-2 Blok, Daire: 26, Demetevler, Ankara, Turkey

Abstract

Objective:

To report epidemiologic, bacteriologic, and clinical features of a Chryseobacterium meningosepticum outbreak.

Design:

Outbreak investigation.

Setting:

A neonatal intensive care unit (NICU) of a referral teaching hospital.

Methods:

During 2 weeks in September 2001, four neonates in the NICU developed sepsis and underwent laboratory investigation. Multiple samples were obtained for cultures from endotracheal tubes, mechanical ventilators and humidifier boxes, infant incubators, parenteral and antiseptic solutions, feeding bottles, sinks, faucets, doors, and healthcare workers.

Results:

C. meningosepticum was isolated from the blood cultures of four patients. The first isolate was identified 5 days after the death of the index case. Although all isolates were ciprofloxacin susceptible in vitro, the remaining three patients did not respond to ciprofloxacin therapy given for 6 or 7 days. Therapy was switched to vancomycin and rifampin and all three patients survived, with one having a complication (hydrocephalus). Environmental surveillance revealed C. meningosepticum in the stock lipid solution as the source of the epidemic. The outbreak was controlled after discontinuation of intravenous lipid solution, restriction of further neonatal admissions, and thorough disinfection of the unit and its equipment.

Conclusion:

Early identification of an epidemic and its source is important in avoiding morbidity and mortality. A contaminated lipid stock bottle was the source of this outbreak associated with multiple cases and one death.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2003

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References

1.Steinberg, JP, Del Rio, C. Other gram-negative bacilli. In: Mandel, GL, Bennet, JE, Dolin, R, eds. Principles and Practice of Infectious Diseases, 5th ed. Edinburgh: Churchill Livingstone; 2000:24592474.Google Scholar
2.Von Graevenitz, A. Ecology, clinical significance and antimicrobial susceptibility of infrequently encountered glucose-nonfermenting gram-negative rods. In: Gilardi, GL, ed. Laboratory Identification and Clinical Aspects. New York: Marcel Dekker; 1985:181232.Google Scholar
3.The Enterobacteriaceae. In: Koneman, EW, Allen, SD, Vanda, WM, Schreckenberger, PC, Winn, WC, eds. Color Atlas and Textbook of Diagnostic Microbiology, 4th ed. Philadelphia: J. B. Lippincott; 1992:185242.Google Scholar
4.Bloch, KC, Nadarafah, R, Jacobs, R. Chryseobacterium meningosepticum: an emerging pathogen among immunocompromised adults. Medicine 1997;76:3041.Google Scholar
5.Schreckenberger, PC, Graevenitz, A. Non-fermentative gram-negative rods. In: Murray, PR, Baron, EJ, Pfaller, MA, Tenover, FC, Yolken, RH, eds. Manual of Clinical Microbiology, 7th ed. Washington, DC: American Society for Microbiology; 1999:552555.Google Scholar
6.National Committee for Clinical Laboratory Standards. Performance Standards for Antimicrobial Disk Susceptibility Tests, 6th ed. Wayne, PA: National Committee for Clinical Laboratory Standards; 1997. Approved standard M2-A6.Google Scholar
7.Amit, Y, Peleg, O, Singer, R, Arad, ID. Intravenous immunoglobulin for Flavobacterium-induced thrombocytopenia in a premature infant. Am J Perinatal 1991;8:161163.CrossRefGoogle Scholar
8.Gardner, P, Griffin, WB, Swartz, MN, Kunz, LJ. Nonfermentative gramnegative bacilli of nosocomial interest. Am J Med 1970;48:735749.Google Scholar
9.Abrahamsen, TG, Finne, PH, Lingoas, E. C. meningosepticum infections in a neonatal intensive care unit. Acta Pediatr Scand 1989;78:5155.CrossRefGoogle Scholar
10.Thong, MC, Puthucheary, SD, Lee, E. C. meningosepticum infection: an epidemiological study in a newborn nursery. J Clin Pathol 1981;34:429433.CrossRefGoogle Scholar
11.Hogue, SN, Graham, J, Kaufmann, ME, Tabagchali, S. Chryseobacterium meningosepticum outbreak associated with colonization of water taps in a neonatal intensive care unit. J Hosp Infect 2001;47:188192.CrossRefGoogle Scholar
12.Hazuka, BT, Dafoni, AS, Talbot, K, Keen, BM. Two outbreaks of C. meningosepticum type E in a neonatal intensive care unit. J Clin Microbiol 1997;6:450455.Google Scholar
13.Bruun, B, Tversrupjensen, E, Lundstrom, K, Andersen, GE. C. meningosepticum infection in a neonatal ward. Eur J Clin Microbiol Infect Dis 1989;816:509514.Google Scholar
14.Dooley, JR, Nims, LJ, Lipp, VH, Beard, A, Delaney, LT. Meningitis of infants caused by C. meningosepticum: report of a patient and analysis of 63 infections. J Trop Pediatr 1980;26:2430.Google Scholar
15.Muder, RR, Brennen, C, Goetz, AM, Wagener, MM. Association with prior fluoroquinolone therapy of widespread ciprofloxacin resistance among gram-negative isolates in a Veterans Affairs medical center. Antimicrob Agents Chemother 1991;35:256258.Google Scholar
16.Horington, SP, Perlino, CA. C. meningosepticum sepsis: disease due to bacteria with unusual antibiotic susceptibility. South Med J 1981;74:764766.Google Scholar
17.Johny, M, Khufdash, FA, Elhag, KM. Antimicrobial treatment of C. meningosepticum infection. Ann Trop Paediatr 1983;3:125128.Google Scholar
18.Di Pentima, MC, Mason, EO Jr, Kaplan, SL. In vitro antibiotic synergy against Flavobacterium meningosepticum: implications for therapeutic options. Clin Infect Dis 1998;26:11691176.CrossRefGoogle ScholarPubMed
19.Tizer, KB, Cervia, JS, Dunn, AM, Stavola, JJ, Noel, GJ. Successful combination vancomycin and rifampin therapy in a newborn with community acquired C. meningosepticum neonatal meningitis. Pediatr Infect Dis J 1995;14:916917.Google Scholar
20.Ratner, H. C. meningosepticum. Infect Control 1984;5:237239.CrossRefGoogle Scholar
21.Lee, EL, Robinson, MJ, Thong, ML, Puthucheary, SD. Rifamycin in neonatal flavobacteria meningitis. Arch Dis Child 1976;51:209213.Google Scholar