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Two outbreaks of Flavobacterium meningosepticum type E in a neonatal intensive care unit
Abstract:
Two separate outbreaks due to Flavobacterium meningosepticum type E occurred in a neonatal intensive care unit in March-April and July 1975. The first outbreak involved all five infants in the unit. Two infants developed meningitis, one had bacteremia, and two were colonized. During the second outbreak, five of seven infants were colonized but none developed disease. The upper respiratory tract was colonized first in most instances, and the organism persisted at this site for a mean of 17.3 days. Duration of colonization was more prolonged in infants receiving antibiotics than in untreated infants. Extensive environmental surveillance failed to demonstrate a reservoir, however, F. meningosepticum was recovered from three nasoendotracheal tubes and from an aerosol tube before colonization of four infants. The organism was resistant to most antimicrobial colonization of four infants. The organism was resistant to most antimicrobial agents tested and developed resistance to others during the treatment course of one infant. Although F. meningosepticum was not recovered from cultures of transport vehicles, several other gram-negative bacteria were isolated and were also resistant to multiple antibiotics.
Insights
Two Flavobacterium meningosepticum outbreaks in a NICU led to meningitis and bacteremia. Prolonged colonization occurred, especially with antibiotic use, and the organism showed antimicrobial resistance.
Area of Science:
- Neonatal infectious diseases
- Microbiology
- Epidemiology
Background:
- Neonatal intensive care units (NICUs) are susceptible to hospital-acquired infections.
- Flavobacterium meningosepticum is an opportunistic pathogen that can cause serious infections in neonates.
Purpose of the Study:
- To investigate two outbreaks of Flavobacterium meningosepticum type E in a NICU.
- To identify the source, transmission patterns, and clinical outcomes of these infections.
Main Methods:
- Epidemiological investigation of patient cases and staff.
- Environmental surveillance, including cultures of equipment and air.
- Antimicrobial susceptibility testing of isolated strains.
Main Results:
- Two outbreaks occurred in 1975, affecting multiple infants.
- The upper respiratory tract was the primary site of colonization, with prolonged persistence.
- Antibiotic use was associated with longer colonization duration.
- F. meningosepticum demonstrated resistance to multiple antimicrobial agents, with some strains developing further resistance.
- Environmental sampling identified F. meningosepticum in nasoendotracheal and aerosol tubes, suggesting potential iatrogenic transmission.
Conclusions:
- Flavobacterium meningosepticum outbreaks in NICUs can lead to significant colonization and invasive disease.
- Environmental contamination of medical devices may play a role in transmission.
- Antimicrobial resistance is a concern, complicating treatment and potentially prolonging colonization.