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Acute Emergence of Elizabethkingia meningoseptica Infection among Mechanically Ventilated Patients in a Long-Term Acute Care Facility

Published online by Cambridge University Press:  02 January 2015

Kingsley N. Weaver ,
Roderick C. Jones ,
Rosemary Albright ,
Yolanda Thomas ,
Carlos H. Zambrano ,
Michael Costello ,
Janet Havel ,
Joel Price  and
Susan I. Gerber
Kingsley N. Weaver*
Affiliation:
Chicago Department of Public Health, Chicago
Roderick C. Jones
Affiliation:
Chicago Department of Public Health, Chicago
Rosemary Albright
Affiliation:
Advocate Hospitals, Chicago
Yolanda Thomas
Affiliation:
Advocate Hospitals, Chicago
Carlos H. Zambrano
Affiliation:
Advocate Hospitals, Chicago
Michael Costello
Affiliation:
Chicago, and ACL Clinical Laboratories, Rosemont, Illinois
Janet Havel
Affiliation:
Chicago, and ACL Clinical Laboratories, Rosemont, Illinois
Joel Price
Affiliation:
Illinois Department of Public Health, Chicago
Susan I. Gerber
Affiliation:
Chicago Department of Public Health, Chicago
*
Chicago Dept of Public Health, 2160 W Ogden Ave, Chicago, IL 60612 (Weaver_Kingsley@cdph.org)
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Extract

Objective.

To describe an outbreak of infection associated with an infrequently implicated pathogen, Elizabethkingia meningoseptica, in an increasingly prominent setting for health care of severely ill patients, the long-term acute care hospital.

Design.

Outbreak investigation.

Setting.

Long-term acute care hospital with 55 patients, most of whom were mechanically ventilated.

Methods.

We defined a case as E. meningoseptica isolated from any patient specimen source from December 2007 through April 2008, conducted an investigation of case patients, obtained environmental specimens, and performed microbiologic testing.

Results.

Nineteen patients had E. meningoseptica infection, and 8 died. All case patients had been admitted with respiratory failure that required mechanical ventilation. Among the 8 individuals who died, the time from collection of the first specimen positive for E. meningoseptica to death ranged from 6 to 43 days (median, 16 days). Environmental sampling was performed on 106 surfaces; E. meningoseptica was isolated from only one swab. Three related pulsed-field gel electrophoresis patterns were identified in patient isolates; the environmental isolate yielded a fourth, unrelated pattern.

Conclusion.

Long-term acute care hospitals with mechanically ventilated patients could serve as an important transmission setting for E. meningoseptica. This multidrug-resistant bacterium could pose additional risk when patients are transferred between long-term acute care hospitals and acute care hospitals.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 31 , Issue 1 , January 2010 , pp. 54 - 58
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2010

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