Related Experiment Videos
Flavobacterium meningosepticum infection in a neonatal ward
B Bruun1, E T Jensen, K Lundstrøm
1Department of Clinical Microbiology, Copenhagen, Denmark.
Abstract:
An outbreak of infections due to Flavobacterium meningosepticum type C in a neonatal intensive care unit is described. During a period of two weeks, two infants developed meningitis and a third was colonized in the respiratory tract and had transient bacteremia. The two meningitis patients were treated with clindamycin, rifampicin and cefotaxime systemically, plus rifampicin intraventricularly. Bacteriological eradication was achieved within 48 h, and both infants recovered from the meningitis without apparent neurological sequelae; however, one infant died two months later of unrelated causes. Environmental surveillance cultures failed to demonstrate a reservoir for the epidemic strain, but other Flavobacterium strains were recovered. Two clinically healthy infants were found to be colonized in the nasopharynx with strains that were extremely difficult to differentiate phenotypically from the epidemic strain. Extensive characterization of strains is necessary in order to differentiate between strains and subsequently to determine a certain source of infection.
Insights
A Flavobacterium meningosepticum type C outbreak in a NICU affected two infants with meningitis and one with bacteremia. Prompt treatment led to recovery, but strain differentiation remains challenging.
Area of Science:
- Neonatal Intensive Care Unit (NICU) infections
- Clinical microbiology
- Infectious disease epidemiology
Background:
- Neonatal intensive care units (NICUs) are vulnerable settings for healthcare-associated infections.
- Flavobacterium species, particularly Flavobacterium meningosepticum, can cause serious infections in neonates.
Observation:
- An outbreak of Flavobacterium meningosepticum type C infections occurred in a NICU over two weeks.
- Two infants developed meningitis, and a third experienced respiratory colonization and transient bacteremia.
- Affected infants were treated with clindamycin, rifampicin, and cefotaxime, with intraventricular rifampicin for meningitis patients.
Findings:
- Bacteriological eradication was achieved within 48 hours in meningitis patients.
- Both infants recovered from meningitis without neurological sequelae; one later died from unrelated causes.
- Environmental cultures did not identify the epidemic strain's reservoir, though other Flavobacterium strains were found.
- Phenotypically similar strains colonized two healthy infants, highlighting diagnostic challenges.
Implications:
- Effective treatment regimens can lead to favorable outcomes for neonatal meningitis.
- Distinguishing epidemic strains from other Flavobacterium strains is crucial for source identification and infection control.
- Further research into strain characterization is necessary to pinpoint infection sources in NICUs.