Epidemiological analysis of Elizabethkingia meningoseptica infection cluster among mechanically ventilated pediatric intensive care patients

Abstract

Background: Elizabethkingia meningoseptica is frequently found in hospital environments and usually associated with healthcare-associated infections (HAIs), particularly in patients in the intensive care units (ICU). The current study report an outbreak of E. meningoseptica infection/colonization in the pediatric intensive care unit, highlighted the infection control methods used to stem the spread.Methods: During a period of 7 months, May-November 2015, 4 patients were infected/ colonized by E. meningoseptica. Infection control measures were re-emphasized after each case and environmental swabs were cultured to detect possible source. Follow up for 25 months to ensure eradication of the pathogen.Results: Four patients were colonized/ infected with E. meningoseptica, their mean age 22 months. The average time patients spent in ICU between admission and isolation of E. meningoseptica was 27.5±19.2 days. All patients were mechanically ventilated. 25% E. meningoseptica isolated from blood causing healthcare associated Central Line Associated Blood Stream Infection (CLABSI) while it was isolated from endotracheal tube (ETT) secretion in 75% as healthcare associated colonization. The 4 isolates confirmed as identical using pulsed field gel electrophoresis (PFGE).Conclusions: Intensive infection control measures including healthcare workers education, emphasizing hand hygiene, comprehensive cleaning and disinfection of equipment and the environment are important to eradicate the bacterium.

Cerebral Salt Wasting Due to Bacteremia Caused by Elizabethkingia meningoseptica: A Case Report

“…The prevalence of infection caused by these bacteria is still unknown, but it most likely spreads through the water environment, mechanical ventilation, and some medical devices in hospitals. The infection can also be spread through drinking water, water remain in the washer tub, water disinfectants, saline solutions used for flushing procedures, hand of hospital staff, infant formulas, and some medical equipment (1). In the current case, the patient was cared for in a child care center at the hospital before getting sick.…”

“…These bacteria can be opportunistic pathogens in newborns and immunocompromised patients (4,5). Pneumonia and soft tissue infections are caused by E. meningoseptica colonization of mucous membrane in the airways and non-intact skin (1). Based on data from 1966 to 2005, E. meningoseptica could cause soft tissue infection in some cases as cellulitis, fasciitis, and infection in burn injury.…”

Clinical features and outcomes of critically ill patients with Elizabethkingia meningoseptica: an emerging pathogen

“…Our study identified and analyzed Elizabeth meningoseptica infections in patients with underlying comorbidities, particularly in patients that required frequent hospitalizations. While many isolated case reports and series have been reported [11][12][13][14][15][16], only a few [17] have included more than four Elizabethkingia cases (Table 2). There are no reports on Elizabethkingia cases from Pakistan.…”

“…The outcomes have been variable, with significant mortality among neonates [ 17 ]. However, patients with isolates susceptible to quinolones and treated with Ciprofloxacin had better survival outcomes [ 14 ]. This result is similar to patients that of who were treated with a quinolone in our study.…”

Clinical Features and Outcomes of Patients with Elizabethkingia Meningoseptica Infection: An Emerging Pathogen

“…A review of literature was conducted to identify clinical case series reporting infections with Elizabethkingia meningoseptica and their outcomes ( Table 1). While many isolated case reports and series were found [12][13][14][15][16][17], only one [18] looked at Elizabethkingia cases that were more than four in number. Much of the literature covered one or two cases in any given hospital or area, and none of the articles searched yielded a case series of more than 4 cases.…”