A<i>Chryseobacterium meningosepticum</i>Outbreak in a Neonatal Ward

Güngör, Serdal; Özen, Metehan; Akıncı, Ayşehan; Durmaz, Rıza

doi:10.1086/502261

Cited by 67 publications

(65 citation statements)

References 16 publications

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“…Most reported outbreaks among neonates have lasted a few weeks to a few months [5,8]. However, in one outbreak, the same strain of E. meningoseptica was isolated from eight babies over almost two years though most cases were asymptomatic [4].…”

Section: Discussionmentioning

confidence: 99%

“…In the last decade, a disproportionate number of cases of E. meningoseptica infections have been reported from Turkey and Taiwan, two relatively affluent countries with warm climates [5,18,[26][27][28][29]. The reasons for this are unclear.…”

Section: Discussionmentioning

confidence: 99%

“…Many cases of E. meningoseptica infections have been reported as part of outbreaks which have been attributed to contamination of hospital tap-water, disinfectants, saline, antibiotic solutions, lipid solution, sink drains and respiratory equipment [1,4,5]. In most reported outbreaks, the number of cases of neonatal meningitis was small and rarely exceeded five.…”

Section: Introductionmentioning

confidence: 99%

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An outbreak of Elizabethkingia meningoseptica neonatal meningitis in Mauritius

Issack

Neetoo²

2011

J Infect Dev Ctries

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Introduction: Elizabethkingia meningoseptica is a rare but well-recognised cause of neonatal meningitis. Reported outbreaks have involved very few cases. We describe the management and outcome of a relatively large outbreak of E.meningoseptica neonatal meningitis Methodology: From August 2002 to December 2003, eight cases of meningitis caused by E. meningoseptica occurred among babies admitted to the neonatal ward of Jawarhlal Nehru hospital, Mauritius. In all cases, the organism was isolated from the cerebrospinal fluid. Infection control measures were re-emphasized after each case and environmental swabs were cultured on several occasions. Results: The affected babies were aged 6 to 20 days (mean age of 10 days). Seven of the babies weighed < 2,500 g. All CSF isolates had the same antibiotic susceptibility pattern. Apart from one baby who died shortly after admission, all cases responded to treatment with intravenous piperacillin and oral rifampicin for three weeks. Hydrocephalus developed in two babies and was subsequently fatal in one case. At follow-up of the other cases, one baby had severe neurological sequelae but a full recovery was observed in the other four cases. The source of the outbreak could not be established conclusively. Conclusions: The outcome was better than what has been reported in the medical literature. Prompt identification of the causative organism and initiation of appropriate antimicrobial therapy is essential. The combination of piperacillin and rifampicin should be considered an option for the treatment of E. meningoseptica neonatal meningitis if supported by properly performed antibiotic susceptibility test results.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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An outbreak of Elizabethkingia meningoseptica neonatal meningitis in Mauritius

Issack

Neetoo²

2011

J Infect Dev Ctries

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“…Most current studies have focused on the molecular epidemiology and possible transmission route of MDR GNB in NICU patients, [8][9][10][11] and clinical data with regard to MDR GNB have only been available in small case series or on a single outbreak. 12,13 Understanding the characteristics that differentiate critically ill neonates at risk of infection due to MDR GNB from those caused by a non-MDR strain will assist clinicians with an early treatment decision for GNB bacteremia. We therefore conducted this study to assess the incidence of, risk factors for acquisition, antibiotic therapy for, and outcomes of MDR GNB bacteremia in NICU patients.…”

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confidence: 99%

Risk Factors and Outcomes for Multidrug-Resistant Gram-Negative Bacteremia in the NICU

et al. 2014

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WHAT'S KNOWN ON THIS SUBJECT:There is a perception that Gram-negative bacilli (GNB) bloodstream infection is increasing in the NICU, and those infections caused by a multidrug-resistant (MDR) strain are a growing threat to hospitalized patients. WHAT THIS STUDY ADDS:Exposure to broad-spectrum antibiotics is the most important risk factor for MDR GNB bacteremia, which is associated with higher mortality. Neonates with risk factors for bacteremia caused by a MDR GNB strain may benefit from empirical antimicrobial therapy with carbapenem. abstract OBJECTIVES: To assess the risk factors antibiotic therapy and outcomes of multidrug-resistant (MDR) Gram-negative bacilli (GNB) bacteremia in NICU patients. METHODS:Episodes of MDR GNB bacteremia were compared with a non-MDR GNB bacteremia group in an 8-year cohort study. RESULTS:Of 1106 bacteremias, 393 (35.5%) were caused by GNB. Seventy (18.6%) were caused by an MDR strain. The most frequent mechanism of resistance was extended-spectrum b-lactamase production (67.1%), mainly by Klebsiella pneumoniae (59.6%). Previous antibiotic exposure to third-generation cephalosporin (odds ratio [OR]: 5.97; 95% confidence interval [CI]: 2.37-15.08; P , .001) and carbapenem (OR: 3.60; 95% CI: 1.26-10.29; P = .017) and underlying renal disease (OR: 7.08; 95% CI: 1.74-28.83; P = .006) were identified as independent risk factors for MDR GNB acquisition. Patients with MDR GNB bacteremia more likely received inadequate initial antibiotic therapy (72.9% vs 7.8%; P , .001) had higher rates of infectious complication (21.4% vs 10.5%; P = .011) and overall case fatality 1rate (28.6% vs 10.5%; P , .001). Independent risk factors for overall mortality were presence of infectious complications after bacteremia (OR: 3.16; 95% CI: 1.41-7.08; P = .005) and underlying secondary pulmonary hypertension with or without cor pulmonale (OR: 6.19; 95% CI: 1.88-20.31; P = .003).CONCLUSIONS: MDR GNB accounted for 18.6% of all neonatal GNB bacteremia in the NICU, especially in those with previous broad-spectrum antibiotic therapy and underlying renal disease. The most frequent mechanism of resistance was extended-spectrum b-lactamase (ESBL) production. Neonates with MDR GNB were more likely to develop infectious complications, which were independently associated with a higher overall case-fatality rate. Pediatrics 2014;133:e322-e329

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“…2 Infections are severe especially in preterm neonates and occurring in first two weeks of life with a high mortality rate. 3,4 Generally E. meningoseptica infections are supposed to be nosocomial and affect immunocompromised hosts.…”

Section: Discussionmentioning

confidence: 99%

Elizabethkingia meningoseptica: an emerging threat

Shah

Soodhana

Kalathia

et al. 2017

Int J Contemp Pediatr

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Infection by Elizabethkingia meningoseptica (E.meningoseptica) is very rare. It is associated with neonatal meningitis and other infections, especially in preterm neonates. We report a case of preterm neonate infected by E.meningoseptica clinically presented with meningitis and necrotizing enterocolitis. The patient succumbed in spite of timely diagnosis and institution of appropriate antibiotics. Although rare but infections casued by E.meningoseptica are often severe and life threatening. It should be considered as an emerging threat and efforts to identify and prompt treatment should be considered in neonates suffering from meningitis.

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AChryseobacterium meningosepticumOutbreak in a Neonatal Ward

Abstract: 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.

Cited by 67 publications

References 16 publications

An outbreak of Elizabethkingia meningoseptica neonatal meningitis in Mauritius

An outbreak of Elizabethkingia meningoseptica neonatal meningitis in Mauritius

Risk Factors and Outcomes for Multidrug-Resistant Gram-Negative Bacteremia in the NICU

Elizabethkingia meningoseptica: an emerging threat

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