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Flavobacterium meningosepticum infections in a neonatal intensive care unit
T G Abrahamsen1, P H Finne, E Lingaas
1Department of Pediatrics, National Hospital, Oslo, Norway.
Abstract:
An outbreak of nosocomial infections by Flavobacterium meningosepticum in a neonatal intensive care unit is described. During a period of eleven weeks two patients presented with septicaemia and meningitis. In addition, nine patients were found to be colonized and three of these neonates developed septicaemia. The infected patients were treated with clindamycin and piperacillin. All the patients survived, but the neonates with meningitis developed hydrocephalus. An extensive bacteriological screening of the staff was negative, but in the ward environment, F. meningosepticum was found around sinks, on rubber stoppers for milk bottles and on "cleaned" teats. Several infection control measures were instituted. Established routines were revised, with particular emphasis on the handling of objects containing or in regular contact with water.
Insights
An outbreak of Flavobacterium meningosepticum caused nosocomial infections in a NICU. Environmental contamination, not staff, was identified as the source, leading to revised infection control measures.
Area of Science:
- Neonatal Intensive Care Unit (NICU) infections
- Bacterial pathogenesis and epidemiology
Background:
- Nosocomial infections pose significant risks to vulnerable neonates.
- Flavobacterium meningosepticum is an opportunistic pathogen that can cause severe infections.
Purpose of the Study:
- To describe an outbreak of Flavobacterium meningosepticum infections in a NICU.
- To identify the source and transmission routes of the outbreak.
- To evaluate the effectiveness of control measures.
Main Methods:
- Retrospective review of clinical cases and microbiological data.
- Bacteriological screening of patients, staff, and the ward environment.
- Implementation and assessment of infection control interventions.
Main Results:
- Two neonates developed meningitis and septicemia; nine others were colonized, with three progressing to septicemia.
- Flavobacterium meningosepticum was isolated from the ward environment (sinks, milk bottle stoppers, teats), not from staff.
- All infected patients survived, but meningitis cases developed hydrocephalus.
Conclusions:
- Environmental contamination is a likely source of Flavobacterium meningosepticum outbreaks in NICUs.
- Revised infection control practices focusing on water-associated items are crucial.
- Prompt treatment and environmental remediation can mitigate severe outcomes.