Chryseobacterium (Flavobacterium) meningosepticum outbreak associated with colonization of water taps in a neonatal

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S N Hoque1, J Graham, M E Kaufmann

  • 1The Department of Medical Microbiology, St Bartholomew's and the Royal London School of Medicine and Dentistry, Whitechapel, UK.

The Journal of Hospital Infection
|March 15, 2001
PubMed

Insights

A multi-resistant Chryseobacterium (Flavobacterium) meningosepticum outbreak in a neonatal intensive care unit was linked to sink taps. Control involved enhanced hygiene and water system improvements.

Area of Science:

  • Medical Microbiology
  • Infectious Diseases
  • Public Health

Background:

  • A multi-resistant strain of Chryseobacterium (Flavobacterium) meningosepticum emerged in a neonatal intensive care unit (NICU) between September 1994 and May 1996.
  • The identified strain exhibited resistance to multiple antibiotics, including ampicillin, ceftazidime, imipenem, gentamicin, ciprofloxacin, and trimethoprim-sulphamethoxazole.

Purpose of the Study:

  • To investigate an outbreak of multi-resistant Chryseobacterium (Flavobacterium) meningosepticum affecting neonates in an NICU.
  • To identify the source of the outbreak and determine the transmission dynamics of the resistant bacterial strain.

Main Methods:

  • Isolation and characterization of Chryseobacterium (Flavobacterium) meningosepticum from affected neonates and the NICU environment.
  • Pulsed-field gel electrophoresis (PFGE) was employed to compare patient and environmental isolates, confirming a single strain responsible for the outbreak.
  • Environmental screening focused on potential sources, including sink taps and water systems.

Main Results:

  • Eight neonates were colonized or infected, with two cases of invasive disease (pneumonia, septicaemia, and meningitis).
  • Chryseobacterium (Flavobacterium) meningosepticum was recovered from sink taps, implicating the water supply as the likely source.
  • PFGE analysis confirmed that patient and environmental isolates were genetically identical, representing a single outbreak strain.

Conclusions:

  • The outbreak was attributed to contamination of the NICU water system, specifically sink taps, with a multi-resistant Chryseobacterium (Flavobacterium) meningosepticum strain.
  • Implementation of enhanced hand hygiene protocols (alcoholic handrub) and the use of sterile water for infant care were crucial in controlling the outbreak.
  • Environmental remediation, including repair and chlorination of water tanks and replacement of sink taps, successfully resolved the outbreak.

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